Safety of once-daily insulin detemir in patients with type 2 diabetes treated with oral hypoglycemic agents in routine clinical practice

Stuart Ross, Grzegorz Dzida, Qiuhe Ji, Marcel Kaiser, Robert Ligthelm, Luigi Meneghini, Avideh Nazeri, Domingo Orozco-Beltran, Changyu Pan, Anne Louise Svendsen, Jean François Yale, Chang Yu Pan, Andreas Liebl, Eddy Karnieli, Salvatore Caputo, Alberto Maran, Luisa Raimundo, Sara Artola, Taner Damci, Sazi ImamogluJiten Vora, Kamlesh Khunti

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Background: The aim of the present study was to identify demographic and treatment factors that were predictive of hypoglycemia in a large cohort of type 2 diabetic patients initiating insulin detemir. Methods: The present 24-week observational study of insulin initiation included 17374 participants from 10 countries. Severe hypoglycemia was defined as an event requiring third party assistance; minor hypoglycemia was defined as a daytime or nocturnal glucose measurement <3.1mmol/L. Results: Prior to initiating insulin therapy, 4.9% of the cohort reported hypoglycemia (pre-insulin hypoglycemia), with most (94.2%) reporting minor events and 9.6% reporting severe events. Compared with patients without pre-insulin hypoglycemia, those with pre-insulin hypoglycemia had a higher incidence of events of minor hypoglycemia (1.72 vs 4.46 events per patient-year [ppy], respectively), nocturnal hypoglycemia (0.25 vs 1.09 events ppy, respectively), and severe hypoglycemia (<0.01 vs 0.04 events ppy, respectively) at final visit. Age (P<0.047), body mass index (P<0.001), a prior history of microvascular disease (P<0.001), pre-insulin hypoglycemia (P<0.001), increased number of oral hypoglycemic agents (OHAs; P<0.001), OHA intensification (P<0.001), and the use of glinides (P=0.004) were all found to be independently associated with the occurrence of hypoglycemia during the study. Conclusions: Once-daily insulin detemir therapy was safe and effective, and rates of hypoglycemia were low. Concerns about hypoglycemia should not deter the initiation of basal insulin analogs.

Original languageEnglish (US)
Pages (from-to)243-250
Number of pages8
JournalJournal of Diabetes
Volume6
Issue number3
DOIs
Publication statusPublished - 2014

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Keywords

  • Ambulatory care
  • Basal insulin
  • Oral hypoglycemic agent
  • Sulfonylurea
  • Type 2 diabetes mellitus

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Medicine(all)

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