Objective To compare the blood glucose level and associated hypoglycemia risks by using insulin Glargine or human NPH both combined with Glipizide GITS in the treatment of type 2 diabetic patients.
Methods Fifty-six cases with inadequate glycemia control by sulfonylurea and/or other oral agents were randomized in two groups (3∶1). In the Glarine group, 42 patients were given Clipizide GITS 5 mg every morning and injection of Glargine at bedtime daily, while 14 patients in the NPH group were given Clipizide GITS 5 mg every morning and injection of NPH at bedtime daily. The dosage of insulin was adjusted by FBG level, seeking a target of FBG＜6.7 mmol/L, and the treatment lasted for 12 weeks. The blood glucose level and incidence of hypoglycemia were observed. The daily dosages of Glargine and NPH were recorded to analyze their relations between FBG and BMI at the beginning of the trial.
Results Mean of FBG and daily glucose profile were similar in the 2 groups, but the incidence of hypoglycemia in the Glargine group was significantly lower than that in the NPH group (3 cases in the Glargine group, 7.1%, 5 cases in the NPH group, 35.7%, χ2=7.0, P =0.008). Mean daily dosages of glargine at the end point were closely related to FBG and BMI at baseline.
Conclusions Bedtime injection of Glargine combined with Glipizide GITs can achieve target blood glucose control and is safer than NPH. This simple “one pill-one injection” regimen may help us achieve recommended blood glucose control targets with better patients’ compliance.
Citation：
BU Shi,XING Xiaoyan,WANG Na,ZHAO Wen hui,YANG Wenying. Evaluation of the Efficacy and Safety of Once Daily Injection of Glargine Combined with Glipizide GITS in the Treatment of Type 2 Diabetes Mellitus. Chinese Journal of Evidence-Based Medicine, 2004, 04(7): 464-467. doi:
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Copyright © the editorial department of Chinese Journal of Evidence-Based Medicine of West China Medical Publisher. All rights reserved
| 1. |
［1］UKPDS Study Group.Stratton IM,Adler AI,Neil HAW,Matthews DR,Manley SE,Cull CA,Hadden D,Turner RC,Holman RR.Association of glycaemia with macrovascular and microvascular complications of Type 2 diabetes:prospective observational study (UKPDS 35) [J].BMJ,2000; 321(12):405-412.
|
| 2. |
［2］UKPDS Study Group.Klein R,Klein BE,Moss SE.Relation of glycemic control to diabetic microvascular complications indiabetes mellitus[J].Ann Intern Med,1996;124(1 Pt 2):90-96.
|
| 3. |
［3］Wright A,Burden ACF,Paisey RB.Sulfonylurea Inadequacy:Efficacy of addition of insulin over 6 years in patients with type 2 diabetes in the UK Prospective Diabetes Study (UKPDS 57)[J].Diabetes Care,2002; 25(2):330-336.
|
| 4. |
［4］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[J].Diabetes Care,2000; 23(8):1 130-1 136.
|
| 5. |
［5］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[J].Diabetes Care,2003; 26(11):3 080-3 086.
|
| 6. |
［6］UKPDS Study Group.Overview of six years’ therapy of type 2 diabetes-a progressive disease (UKPDS 16)[J].Diabetes Care,1995; 44(11):1 249-1 258.
|
| 7. |
［7］Turner RC,Cull CA,Frighi V,Holman RR.Glycemic control with diet,sulfonylurea,metformin,or insulin in patients with type 2 diabetes mellitus:progressive requirement for multiple therapies (UKPDS 49).UK Prospective Diabetes Study (UKPDS) Group[J].JAMA,1999; 281(21):2 005-2 012.
|
| 8. |
［8］Matthaei S.Endocrine review[M],21(6):585-618.
|
- 1. ［1］UKPDS Study Group.Stratton IM,Adler AI,Neil HAW,Matthews DR,Manley SE,Cull CA,Hadden D,Turner RC,Holman RR.Association of glycaemia with macrovascular and microvascular complications of Type 2 diabetes:prospective observational study (UKPDS 35) [J].BMJ,2000; 321(12):405-412.
- 2. ［2］UKPDS Study Group.Klein R,Klein BE,Moss SE.Relation of glycemic control to diabetic microvascular complications indiabetes mellitus[J].Ann Intern Med,1996;124(1 Pt 2):90-96.
- 3. ［3］Wright A,Burden ACF,Paisey RB.Sulfonylurea Inadequacy:Efficacy of addition of insulin over 6 years in patients with type 2 diabetes in the UK Prospective Diabetes Study (UKPDS 57)[J].Diabetes Care,2002; 25(2):330-336.
- 4. ［4］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[J].Diabetes Care,2000; 23(8):1 130-1 136.
- 5. ［5］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[J].Diabetes Care,2003; 26(11):3 080-3 086.
- 6. ［6］UKPDS Study Group.Overview of six years’ therapy of type 2 diabetes-a progressive disease (UKPDS 16)[J].Diabetes Care,1995; 44(11):1 249-1 258.
- 7. ［7］Turner RC,Cull CA,Frighi V,Holman RR.Glycemic control with diet,sulfonylurea,metformin,or insulin in patients with type 2 diabetes mellitus:progressive requirement for multiple therapies (UKPDS 49).UK Prospective Diabetes Study (UKPDS) Group[J].JAMA,1999; 281(21):2 005-2 012.
- 8. ［8］Matthaei S.Endocrine review[M],21(6):585-618.
