Patient Care Endocrinology & Cardiology - December 2007 - (Page 11)

Basal insulins I due to adverse effects, mainly nausea and vomiting. Accordingly, exenatide may be an appropriate additional therapy for obese patients failing metformin and an SU with HbA1c between 7% and 9%. LIMITATIONS OF INSULIN GLARGINE AND DETEMIR Despite the superiority of the new basal insulin analogs over NPH insulin in terms of decreasing the incidence of hypoglycemia, they generally failed to show greater reduction in HbA1c levels. It should be emphasized that all trials evaluating insulin glargine and detemir were open-label (NPH insulin is cloudy, REFERENCES 1. Hirsch IB. Insulin analogues. N Engl J Med. 2005;352:174-183. 2. Mooradian AD, Bernbaum M, Albert S. Narrative review: a rational approach to starting insulin therapy. Ann Intern Med. 2006;145:125-134. 3. Hagedorn HC, Jensen BN, Krarup NB, et al. Protamine insulinate. JAMA. 1936;106:177-180. 4. Krayenbuhl C, Rosenberg T. Crystalline protamine insulin. Rep Steno Memorial Hosp. 1946;1:60-73. 5. DeWitt DE, Hirsch IB. Outpatient insulin therapy in type 1 and type 2 diabetes mellitus [scientific review]. JAMA. 2003;289:2254-2264. 6. Fanelli CG, Pampanelli S, Porcellati F, et al. Administration of neutral protamine Hagedorn insulin at bedtime versus with dinner in type 1 diabetes mellitus to avoid nocturnal hypoglycemia and improve control. Ann Intern Med. 2002;136:504-514. 7. Guerci B, Sauvanet JP. Subcutaneous insulin: pharmacokinetic variability and glycemic variability. Diabetes Metab. 2005;31:4S7-4S24. 8. Jehle PM, Micheler C, Jehle DR, et al. Inadequate suspension of neutral protamine Hagendorn insulin in pens. Lancet. 1999;354:1604-1607. 9. Hamann A, Matthaei S, Rosak C, et al for the HOE901/4007 Study Group. A randomized clinical trial comparing breakfast, dinner, or bedtime administration of insulin glargine in patients with type 1 diabetes. Diabetes Care. 2003;26:1738-1744. 10. Ashwell SG, Gebbie J, Home PD. Optimal timing of injection of once daily insulin glargine in people with type 1 diabetes using insulin lispro at meal times. Diabetic Medicine. 2006;23:46-52. 11. Riddle MC, Rosenstock J, Gerich J; Insulin Glargine 4002 Study Investigators. The treat-to-target trial: randomized addition of glargine or human NPH insulin to oral therapy of type 2 diabetic patients. Diabetes Care. 2003;26(11):3080-3086. 12. Yki-Jarvinen H, Dressler A, Ziemen M. The HOE 901/3002 Study Group. Less nocturnal hypoglycemia and better post-dinner glucose control with bedtime insulin glargine compared with bedtime NPH insulin during insulin combination therapy in type 2 diabetes. Diabetes Care. 2000;23:1130-1136. 13. Lepore M, Pampanelli S, Fanelli C, et al. Pharmacokinetics and pharmacodynamics of subcutaneous injection of long-acting human insulin analog glargine, NPH insulin, and ultralente human insulin and continuous subcutaneous infusion of insulin lispro. Diabetes. 2000;49:2142-2148. 14. Fritsche A, Schweitzer MA, Haring H, and the 4001 Study Group. Glimepiride combined with morning insulin glargine, bedtime neutral protamine Hagedorn insulin, or bedtime insulin glargine in patients with type 2 diabetes: a randomized, controlled trial. Ann Intern Med. 2003;138:952-959. 15. Fulcher GR, Gilbert RE, Yue DK. Glargine is superior to neutral protamine Hagedorn for improving glycated haemoglobin and fasting blood glucose levels during intensive insulin therapy. Intern Med J. 2005;35:536-542. 16. Ratner RE, Hirsch IB, Neifing JL, et al. Less hypoglycemia with insulin glargine in intensive insulin therapy for type 1 diabetes. US Study Group of insulin glargine in type 1 diabetes. Diabetes Care. 2000;23:639-643. 17. Plank J, Bodenlenz M, Sinner F, et al. A double-blind, randomized, doseresponse study investigating the pharmacodynamic and pharmacokinetic properties of the long-acting insulin analog detemir. Diabetes Care. 2005;28:1107-1112. whereas insulin glargine and detemir are clear solutions), and almost all of them were sponsored by the corresponding pharmaceutical companies. Therefore, bias could not be excluded; caution should be exercised when interpreting data. Table 1 compares the cost and advantages and disadvantages of the 3 types of basal insulin (see page 10). I Dr Mikhail discloses that he has no financial relationship with any manufacturer in this area of medicine. The author thanks Marsha Kmec who provided expert assistance in the literature review. 18. Heise T, Nosek L, Ronn BB, et al. Lower within-subject variability of insulin detemir in comparison to NPH insulin and insulin glargine in people with type 1 diabetes. Diabetes. 2004;53:1614-1620. 19. Hermansen K, Davies M, Derezinski T, et al, on behalf of the Levemir treatto-target study group.. A 26-week, randomized, parallel, treat-to-target trial comparing insulin detemir with NPH insulin as add-on therapy to oral glucose-lowering drugs in insulin-naïve people with type 2 diabetes. Diabetes Care. 2006;29:1269-1274. 20. Holman RR, Thorne KI, Farmer AJ, et al; 4-T Study Group. Addition of biphasic, prandial, or basal insulin to oral therapy in type 2 diabetes. N Engl J Med. 2007;357(17):1716-1730. 21. Pieber TR, Treichel HC, Hompesch B, et al. Comparison of insulin detemir and insulin glargine in subjects with type 1 diabetes using intensive insulin therapy. Diabet Med. 2007;24:635-642. 22. Rosenstock J, Davies M, Home PD, et al. Insulin detemir added to oral antidiabetic drugs in type 2 diabetes provides glycemic control comparable to insulin glargine with less weight gain [abstract]. Diabetes. 2006;55 (suppl):A132. 23. Aljabri K, Kozak S, Thompson DM. Addition of pioglitazone or bedtime insulin to maximal doses of sulfonylurea and metformin in type 2 diabetes patients with poor glucose control: a prospective, randomized trial. Am J Med. 2004;116:230-235. 24. Rosenstock J, Sugimoto D, Strange P, et al, on behalf of the Insulin Glargine 4014 Study Investigators. Triple therapy in type 2 diabetes. Insulin glargine or rosiglitazone added to combination therapy of sulfonylurea plus metformin in insulin-naïve patients. Diabetes Care. 2006;29:554-559. 25. Nathan DM, Buse JB, Davidson M, et al. Management of hyperglycemia in type 2 diabetes: A consensus algorithm for the initiation and adjustment of therapy. A consensus statement from the American Diabetes Association and the European Association for the study of Diabetes. Diabetes Care. 2006;29:1963-1971. 26. Nissen SE, Wolski K. Effect of rosiglitazone on the risk of myocardial infarction and death from cardiovascular causes. N Engl J Med. 2007;356: 2457-2471. 27. Mikhail N. Why should we avoid the use of rosiglitazone. South Med J. In press. 28. Heine RJ, Van Gaal LF, Johns D, et al for the GWAA Study Group. Exenatide versus insulin glargine in patients with suboptimally controlled type 2 diabetes: a randomized trial. Ann Intern Med. 2005;143:559-569. www.patientcareonline.com Visit our Web site for ® Click-through links to the Internet resources listed in these pages DECEMBER 2007 PATIENT CARE ENDOCRINOLOGY & CARDIOLOGY 11 http://www.patientcareonline.com

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Patient Care Endocrinology & Cardiology - December 2007 Research Digest Contents Medicine in the News Options for Managing Diabetes: Three Types of Basal Insulin Therapy Using the New AHA Guidelines for Preventing Coronary Heart Disease in Women Cardiovascular and Metabolic Implications of Polycystic Ovary Syndrome Case & Comment Classified Advertising Clinical Clips

Patient Care Endocrinology & Cardiology - December 2007

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