scholarly journals Successful Treatment with Bedtime Basal Insulin Added to Metformin without Weight Gain or Hypoglycaemia over Three Years

2020 ◽  
Vol 9 (4) ◽  
pp. 1153 ◽  
Author(s):  
Bernardo Mertes ◽  
Sybille Gödde ◽  
Michael Piorkowski ◽  
Guido Kramer ◽  
Ulrich Alfons Müller ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Weight Gain ◽  
Observational Study ◽  
Basal Insulin ◽  
Severe Hypoglycaemia ◽  
Duration Of Treatment ◽  
Nph Insulin ◽  
Hba1c Target

The aim of this observational study was to follow-up patients with bedtime basal insulin (NPH insulin) added to metformin. In 285 patients with type 2 diabetes, a therapy with bedtime basal insulin added to metformin was started due to failure to achieve a glycaemic goal. Up until July 2019, 272 patients (95.4%) were followed-up (59.5 y, 92.6 kg, diabetes duration 6.6 y, HbA1c 8.4%/68.6 mmol/mol). HbA1c decreased by −1.2% and bodyweight by −1.7 kg after a duration of 31.7 ± 29.1 (range 2–133) months. Severe hypoglycaemia did not occur. In 144/272 patients (52.9%), the therapeutic goal for HbA1c was achieved over 32.7 months. In 69/272 patients (25.4%), the HbA1c target was achieved over 25.0 months (afterwards, therapy with basal insulin was discontinued because HbA1c was under target). In 36/272 patients (13.2%), the HbA1c goal was achieved until the submission of this manuscript (mean duration of treatment 57.4 ± 28.2 (range 13–121) months). Over 90% of patients with type 2 diabetes and failure of metformin reached their HbA1c goal with additional basal insulin at bedtime over several years in association with a reduction of bodyweight and without any event of severe hypoglycaemia.

scholarly journals Treatment of Type 1 and Type 2 Diabetes Mellitus with Insulin Detemir, a Long-Acting Insulin Analog

2010 ◽  
Vol 3 ◽  
pp. CMED.S5330 ◽  
Author(s):  
Jason R. Young ◽  
Carrie Mcadam-Marx
Keyword(s):  
Type 2 Diabetes ◽  
Weight Gain ◽  
Glycemic Control ◽  
Insulin Glargine ◽  
Basal Insulin ◽  
Insulin Detemir ◽  
Nph Insulin ◽  
Long Acting

Insulin detemir is a long-acting basal insulin approved for use in patients with type 1 (T1DM) or type 2 diabetes (T2DM). Insulin detemir has demonstrated equivalent glycemic control and hypoglycemic risk when compared to insulin glargine, and insulin detemir has generally but not consistently demonstrated less weight gain than insulin glargine in T2DM. The benefits of basal insulin analogs relative to NPH insulin are well recognized, including less FBG variability, lower risk of hypoglycemia, and less weight gain specifically with insulin detemir. However, NPH insulin continues to be widely prescribed, which may be due in part to economic considerations. While NPH insulin generally costs less per prescription, insulin detemir has been shown to be cost effective compared to NPH insulin as well as insulin glargine. Therefore, insulin detemir is an effective option from both clinical and economic perspectives for patients with T1DM or T2DM who require basal insulin to achieve glycemic control.

scholarly journals Advancing Therapy in Suboptimally Controlled Basal Insulin-Treated Type 2 Diabetes: Clinical Outcomes with iGlarLixi versus Premix BIAsp 30 in the SoliMix Randomized Controlled Trial

2021 ◽  
Author(s):  
Julio Rosenstock ◽  
Rifat Emral ◽  
Leobardo Sauque-Reyna ◽  
Viswanathan Mohan ◽  
Carlos Trescolí ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Weight Gain ◽  
Basal Insulin ◽  
Controlled Trial ◽  
Fixed Ratio ◽  
Mean Difference ◽  
Primary Efficacy ◽  
Open Label ◽  
Once Daily

<p><b>Objective: </b>To directly compare the efficacy and safety of a fixed-ratio combination, iGlarLixi, with a premix insulin analog (BIAsp 30) as treatment advancement in type 2 diabetes suboptimally controlled on basal insulin plus oral antihyperglycemic drugs (OADs).</p> <p><b>Research Design and Methods: </b>SoliMix, a 26-week, open-label, multicenter study, randomized adults with suboptimally controlled basal insulin-treated type 2 diabetes (HbA<sub>1c</sub> ≥7.5 % and ≤10 %) to once-daily iGlarLixi or twice-daily BIAsp 30. Primary efficacy endpoints were non-inferiority in HbA<sub>1c</sub> reduction (margin 0.3 %) or superiority in bodyweight change for iGlarLixi versus BIAsp 30.</p> <p><b>Results: </b>Both primary efficacy endpoints were met: after 26 weeks, baseline HbA<sub>1c</sub> (8.6 %) was reduced by 1.3 % with iGlarLixi and 1.1 % with BIAsp 30, meeting non-inferiority (least squares [LS] mean difference [97.5% CI]: -0.2 [-0.4, -0.1] %; p<0.001). iGlarLixi was also superior to BIAsp 30 for bodyweight change (LS mean difference [95% CI] -1.9 [-2.3, -1.4] kg) and percentage of participants achieving HbA<sub>1c</sub> <7 % without weight gain and HbA<sub>1c</sub> <7 % without weight gain and without hypoglycemia (all p<0.001). iGlarLixi was also superior versus BIAsp 30 for HbA<sub>1c</sub> reduction (p<0.001). Incidence and rates of ADA Level 1 and 2 hypoglycemia were lower with iGlarLixi versus BIAsp 30.</p> <p><b>Conclusions: </b>Once-daily iGlarLixi provided better glycemic control with weight benefit and less hypoglycemia than twice-daily premix BIAsp 30. iGlarLixi is a more efficacious, simpler, and well-tolerated alternative to premix BIAsp 30 in suboptimally controlled type 2 diabetes requiring treatment beyond basal insulin plus OAD therapy.</p> <b><br> </b> <p> </p>

Abstract P031: Weight Changes and Their Predictors Among 11,140 Patients With Type 2 Diabetes in The Advance Trial

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Susan van Dieren ◽  
Andre Pascal Kengne ◽  
John Chalmers ◽  
Joline Beulens ◽  
Yvonne van der Schouw ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Weight Gain ◽  
Weight Change ◽  
Glucose Control ◽  
Diabetes Research ◽  
Mixed Effect ◽  
Glucose Lowering ◽  
The Mean

Background/Aim: To determine the baseline characteristics and glucose lowering therapies associated with weight change among subjects with type 2 diabetes. Methods: 11,140 participants in the ADVANCE trial, were randomly assigned to an intensive (aiming for an HbA 1c ≤ 6.5%) or a standard blood glucose control strategy. Weight was measured at baseline and every 6 months over a median follow-up of 5 years. Multivariable linear regression and linear mixed effect models were used to examine predictors of weight change. Results: The mean difference in weight between the intensive and standard glucose control arm during follow-up was 0.75 kg (95% CI: 0.56 to 0.94), p-value<0.001. The mean weight decreased by 0.70 kg (95% CI: 0.53 to 0.87), p <0.001 by the end of follow-up in the standard arm but remained stable in the intensive arm, with a non-significant gain of 0.16 kg (95% CI: -0.02 to 0.34), p=0.075. Baseline factors associated with weight gain were younger age, higher HbA 1c , Caucasian ethnicity and number of glucose lowering medications. Treatment combinations including insulin [3.20 kg (95% CI: 2.90 to 3.50)] and thiazolidinediones [3.05 kg (95% CI: 2.68 to 3.42)] were associated with the greatest weight gain whilst treatment combinations including sulphonylureas were associated with less weight gain [0.71 kg (95%CI: 0.39 to 1.03)] (Figure 1). Conclusion: Intensive glucose control regimens are not necessarily associated with substantial weight gain. Patient characteristic associated with weight change were age, ethnicity, smoking and HbA1c. The main treatment strategies predicting weight gain were the use of insulin and thiazolidinediones. Acknowledgements: This research was supported by a program grant from the National Health and Medical Research Council of Australia, the Center for Translational Molecular Medicine (CTMM) and the Netherlands Heart Foundation, Dutch Diabetes Research Foundation and Dutch Kidney Foundation (PREDICCt).

Abstract 17285: Frequent Consumption of Meals Prepared at Home and Risk of Type 2 Diabetes Among American Men and Women

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Geng Zong ◽  
David M Eisenberg ◽  
Frank B Hu ◽  
Qi Sun
Keyword(s):  
Type 2 Diabetes ◽  
Weight Gain ◽  
Lower Risk ◽  
Fruits And Vegetables ◽  
Hazard Ratio ◽  
Health Study ◽  
Sugar Sweetened Beverage ◽  
At Home

Introduction: The frequency of eating meals prepared at home (MPAH) decreased among Americans over the last 50 years. Eating out has been associated with poor diet quality and weight gain in adolescents and adult. Few studies have examined MPAH frequency in relation to diabetes risk. Hypothesis: Having MPAH is associated with lower risk of Type 2 Diabetes (T2D). Methods: We followed 57,994 women in the Nurses’ Health Study and 41,679 men in the Health Professionals Follow-up Study from 1986 to 2012. Participants were free of diabetes, cardiovascular disease, and cancer at baseline. Weekly frequencies of consuming MPAH were collected at baseline, and summed up as overall MPAH. Results: Participants with more MPAH had higher intake of whole grains, total and low-fat dairy products, fruits, and vegetables, and lower sugar sweetened beverage (SSB) at baseline. However, MPAH turned to be associated with more red meat and low coffee intakes. MPAH was moderately associated with less weight gain during follow-up. Compared to those with 0-6 overall MPAH/week, women with 11-14 MPAH/week had 0.45±0.08kg less weight gain over 8 years, whereas men had 0.41±0.07 kg less weight gain (P<0.001) for the same comparison. During 2.3 million person-years of follow-up, 8959 T2D cases were identified and confirmed in both cohorts. After multivariate adjustment of demographic and lifestyle factors, pooled hazard ratio (95% confidence interval) of T2D were 0.96 (0.90, 1.01), 0.96 (0.87, 1.06), 0.88 (0.83, 0.94) for participants who had 7-8, 9-10, and 11-14 MPAH/week (P for trend<0.001), comparing with those eating 0-6 MPAH/week. Each additional MPAH for lunch was associated with 2% lower risk of T2D, whereas the corresponding value was 4% for dinner (P<0.001 for both). These findings were attenuated when BMI or SSB were further adjusted: the hazard ratio comparing participants with 11-14 MPAH/week to those with 0-6 MPAH/week were 0.95 (0.90, 1.01; P for trend=0.13) with adjusting of BMI, and 0.94 (0.89, 1.00; P for trend=0.09) with adjustment of SSB. Conclusions: These findings suggest that eating more MPAH is associated with a lower risk of T2D overtime, and this relationship may be partly ascribed to less weight gain and lower SSB intake by those who prepare their own meals at home more often.

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