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Glargine Comparable to Lispro As Insulin Choice

HbA1C change for both meets non-inferiority criteria; satisfaction higher with once-daily glargine

FRIDAY, March 28 (HealthDay News) -- The use of a once-daily basal insulin analog offers equally effective glycemic control as three-times daily prandial insulin in type 2 diabetics with poor control on oral hypoglycemics, according to research published in the March 29 issue of The Lancet.

Reinhard G. Bretzel, M.D., of the Justus-Liebig-Universitat in Giessen, Germany, and colleagues analyzed data from an open randomized, controlled trial in which 186 adults took daily insulin glargine and 191 took three-times daily insulin lispro, along with oral hypoglycemic agents. Primary outcome was the change in hemoglobin A1C from baseline to the 44-week endpoint.

The mean change in HbA1C was -1.7 percent in the glargine group and -1.9 percent in the lispro group, which fell within the limits defined for non-inferiority, the researchers report. More patients reached HbA1C of 7 percent or less in the lispro group (69 percent versus 57 percent), but the improvement of patient satisfaction was higher for glargine.

"The addition of insulin glargine to oral hypoglycemic agents is a simple and well-tolerated intervention that can be helpful in overcoming major barriers to timely insulin initiation in settings of primary and secondary care," the authors conclude. "Evidence from the APOLLO study suggests that the addition of insulin glargine to therapies with oral hypoglycemic agents can be regarded as a first-line insulin initiation approach in type 2 diabetes mellitus, as has been recommended in a joint consensus guideline by the American Diabetes Association and European Association for the Study of Diabetes."

This study was funded by Sanofi-Aventis; Sanofi-Aventis Deutschland GmbH is the maker of glargine. Bretzel and co-authors report financial relationships with Sanofi-Aventis and other pharmaceutical companies.

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