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Rigshospitalet - en del af Københavns Universitetshospital
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Comparing effects of insulin analogues and human insulin on nocturnal glycaemia in hypoglycaemia-prone people with Type 1 diabetes

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  • P L Kristensen
  • L Tarnow
  • C Bay
  • K Nørgaard
  • T Jensen
  • H-H Parving
  • H Perrild
  • H Beck-Nielsen
  • J S Christiansen
  • B Thorsteinsson
  • U Pedersen-Bjergaard
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AIMS: To assess the difference between analogue and human insulin with regard to nocturnal glucose profiles and risk of hypoglycaemia in people with recurrent severe hypoglycaemia.

METHODS: A total of 72 people [46 men, mean ± sd age 54 ± 12 years, mean ± sd HbA1c 65 ± 12 mmol/mol (8.1 ± 1.1%), mean ± sd duration of diabetes 30 ± 14 years], who participated in a 2-year randomized, crossover trial of basal-bolus therapy with insulin detemir/insulin aspart or human NPH insulin/human regular insulin (the HypoAna trial) were studied for 2 nights during each treatment. Venous blood was drawn hourly during sleep. Primary endpoints were nocturnal glucose profiles and occurrence of hypoglycaemia (blood glucose ≤ 3.9 mmol/l).

RESULTS: During insulin analogue treatment, the mean nocturnal plasma glucose level was significantly higher than during treatment with human insulin (10.6 vs 8.1 mmol/l). The fasting plasma glucose level was similar between the treatments. Nocturnal hypoglycaemia was registered during 41/101 nights (41%) in the human insulin arm and 19/117 nights (16%) in the insulin analogue arm, corresponding to a hazard ratio of 0.26 (95% CI 0.14 to 0.45; P<0.0001) with insulin analogue.

CONCLUSIONS: Treatment with insulin analogue reduces the occurrence of nocturnal hypoglycaemia assessed by nocturnal glucose profiles in people with Type 1 diabetes prone to severe hypoglycaemia. Nocturnal glucose profiles provide a more comprehensive assessment of clinical benefit of insulin regimens as compared to conventional recording of hypoglycaemia. This article is protected by copyright. All rights reserved.

OriginalsprogEngelsk
TidsskriftDiabetic Medicine
Vol/bind34
Udgave nummer5
Sider (fra-til)625-631
ISSN0742-3071
DOI
StatusUdgivet - 2017

ID: 49676802