The use of insulin glargine, (a single injection of daily insulin) is as effective at controlling blood sugar for people with diabetes as insulin lispro (which has to be injected up to three times a day), and is associated with increased satisfaction among users. These are the conclusions of authors of an Article published in this week’s edition of The Lancet.
Controlling blood sugar can help people with diabetes avoid the occurrence of microvascular events (eg, retinopathy) and, to a lesser extent, macrovascular complications. Blood sugar control is measured using the concentration of haemoglobin A1c in the blood, and concentrations less than 7% (optimally less than 6.5%) can substantially reduce the risk of these complications. The amount of haemoglobin A1c is directly related to the amount of sugar in the blood.
Professor Reinhard G Bretzel, Justus-Liebig-Universität Giessen, Germany, and colleagues did the APOLLO study, a 44-week trial of 418 patients with type 2 diabetes in 69 study sites across Europe and Australia. All patients had diabetes that was not adequately controlled by oral hypoglycaemic drugs, and were randomly assigned to either insulin glargine injected once daily at the same time every day (205 individuals), or to insulin lispro injected three times per day (210).
The investigators found that both groups achieved similar reductions in haemoglobin A1c, with the average decrease in the insulin glargine group -1.7% (from 8.7% to 7.0%); in the insulin lispro group the average decrease was -1.9% (from 8.7% to 6.8%).
The authors conclude: “A therapeutic regimen involving the addition of either basal or prandial insulin analogue is equally effective in lowering haemoglobin A1c. We conclude that insulin glargine provides a simple and effective option that is more satisfactory to patients than is lispro for early initiation of insulin therapy, since it was associated with a lower risk of hypoglycaemia, fewer injections, less blood glucose self monitoring, and greater patient satisfaction than was insulin lispro.”
See also accompanying Comment.
http://multimedia.thelancet.com/pdf/press/Insulin.pdf
Journal
The Lancet