Abstract | AIM: METHODS: Twenty-four subjects with type 2 diabetes [19 men and 5 women, 56.1 +/- 6.6 years, body mass index 32.7 +/- 4.2 kg/m(2), glycosylated haemoglobin (HbA1c) 8.4 +/- 0.8% (mean +/- s.d.)] inadequately controlled by metformin and/or sulfonylureas were randomized to receive additional therapy with either INH administered preprandially using a metered-dose inhaler (MDI), or insulin glargine (GLA) injected subcutaneously at bedtime for 4 weeks. Both inhaled and injected insulin doses were titrated to predefined blood glucose (BG) targets. RESULTS: INH and GLA improved metabolic control to a similar extent. Mean daily BG decreased by 2.8 mmol/l in the INH group (p < 0.001) and by 2.4 mmol/l in the GLA group (p < 0.001). Accordingly, fasting BG (-2.7 vs. -3.6 mmol/l for INH vs. GLA), preprandial- and 2-h postprandial BG, HbA1c (-1.23 vs. -1.05%), body weight (-1.9 vs. -2.3 kg) and serum fructosamine were similarly and significantly reduced in both groups (p < 0.05). Triglycerides decreased significantly with INH (-1.15 micromol/l; p < 0.001) but not with GLA [-0.52 micromol/l; not significant (NS)]. Incidence rates of adverse events did not differ significantly, and there were no indications of respiratory tract irritation. CONCLUSIONS: In subjects with type 2 diabetes inadequately controlled by oral agents, preprandial administration of INH delivered by a MDI provided a comparable metabolic control to bedtime GLA and did not show any safety concerns during a 4-week treatment. These results warrant a more extensive investigation of preprandial treatment with INH in longer term studies.
|
Authors | M Hausmann, S Dellweg, C Osborn, L Heinemann, A Buchwald, R Rosskamp, P Genova, T Heise |
Journal | Diabetes, obesity & metabolism
(Diabetes Obes Metab)
Vol. 8
Issue 5
Pg. 574-80
(Sep 2006)
ISSN: 1462-8902 [Print] England |
PMID | 16918593
(Publication Type: Journal Article, Randomized Controlled Trial)
|
Chemical References |
- Blood Glucose
- Hypoglycemic Agents
- Insulin
- Insulin, Long-Acting
- Sulfonylurea Compounds
- Insulin Glargine
- Metformin
|
Topics |
- Administration, Inhalation
- Administration, Oral
- Adolescent
- Adult
- Blood Glucose
(metabolism)
- Diabetes Mellitus, Type 2
(blood, drug therapy)
- Drug Administration Schedule
- Drug Therapy, Combination
- Female
- Humans
- Hypoglycemic Agents
(administration & dosage)
- Injections, Subcutaneous
- Insulin
(administration & dosage, analogs & derivatives, therapeutic use)
- Insulin Glargine
- Insulin, Long-Acting
- Male
- Metformin
(therapeutic use)
- Middle Aged
- Pilot Projects
- Sulfonylurea Compounds
(therapeutic use)
- Treatment Failure
|