Improving metabolic control in sub-optimally controlled subjects with Type 1 diabetes: comparison of two treatment algorithms using insulin glargine.

Abstract

This study assessed the incidence of severe hypoglycaemia with two insulin glargine titration algorithms: Algorithm 1 (increments of at least 10%, but not exceeding 4U) versus Algorithm 2 (1-6U increments). In this multicenter (n=409), multinational (n=54), open-label, 24-week randomized trial in 2442 subjects with sub-optimally controlled Type 1 diabetes (T1DM), mean prior insulin therapy duration was 14.6+/-10.3 years. The incidence of severe hypoglycaemia was similar with Algorithms 1 and 2 (16.6events/100 patient-years versus 14.4events/100 patient-years). There were similar rates of both symptomatic and nocturnal hypoglycaemia. HbA(1c) and fasting blood glucose (FBG) decreased significantly (baseline to endpoint; p<0.001), and comparably with Algorithms 1 and 2 (HbA(1c): -0.64% versus -0.72%; FBG: -57mg/dL versus -59mg/dL). Mean basal insulin dose increased with both algorithms (+5.7U versus +5.9U). In a diverse population with longstanding T1DM, transfer from any insulin regimen, including basal-bolus or premixed insulin to an insulin glargine-based regimen resulted in significant improvements in glycaemic control, with low rates of severe hypoglycaemia, irrespective of the titration algorithm used.

• Authors: Ramon Gomis, Fred Storms, Ignacio Conget, Patrick Sinnassamy, Melanie Davies, AT.LANTUS Study Group
• Journal: Diabetes research and clinical practice (Diabetes Res Clin Pract) Vol. 77 Issue 1 Pg. 84-91 (Jul 2007) ISSN: 0168-8227 [Print] Ireland
• PMID: 17097185 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Blood Glucose
• Glycated Hemoglobin A
• Hypoglycemic Agents
• Insulin
• Insulin, Long-Acting
• hemoglobin A1c protein, human
• Insulin Glargine

Topics

• Adult
• Blood Glucose (metabolism)
• Diabetes Mellitus, Type 1 (drug therapy, metabolism)
• Female
• Glycated Hemoglobin (metabolism)
• Humans
• Hypoglycemia (prevention & control)
• Hypoglycemic Agents (therapeutic use)
• Insulin (analogs & derivatives, therapeutic use)
• Insulin Glargine
• Insulin, Long-Acting
• Male
• Middle Aged
• Treatment Outcome