The data published by Aventis recently revealed that people with type 2 diabetes treated with the 24-hour basal insulin analog Lantus (insulin glargine [rDNA origin] injection) plus oral antidiabetic medications achieve greater blood glucose (sugar) control, rigorously defined as reaching target A1C= 7 per cent, with less risk of hypoglycemia (abnormally low blood sugar) compared to those people treated with standard twice-daily premixed insulin and no oral agents. These findings were presented at the 40th Annual Meeting of the European Association for the Study of Diabetes in Munich, Germany.
The study included 364 people with type 2 diabetes who were previously inadequately controlled on oral agents and had never been treated with insulin. Patients were either treated with Lantus once-daily injection while continuing oral therapy (Amaryl [glimepiride TABLETS] or another sulfonylurea plus metformin), or discontinued oral agents and received a twice-daily injection of premixed 70 per cent NPH insulin and 30 per cent regular insulin. Fifty percent more patients in the Lantus plus orals treated group achieved target glycemic control (A1C £7%) without having an episode of nocturnal hypoglycemia, compared to those on premixed insulin and no oral medications (p = 0.0013), a release from Aventis said.
"These data confirm that adding basal insulin glargine to oral therapy can help physicians and their patients more safely and effectively restore glycemic control in type 2 diabetes, with significantly less hypoglycemia than twice-daily premixed insulin," said Hans Uwe Janka, the lead investigator and professor of Medicine and Head of Section of Internal Medicine at the Central Hospital Bremen-Nord, Bremen, Germany. "With just one injection and one blood glucose measurement per day, this regimen is cost-effective and easy to initiate. It's decisive evidence for physicians to add basal insulin in patients failing oral therapy," he concluded.
In type 2 diabetes, control of blood glucose tends to worsen progressively over time, even with oral medications. Treatment with insulin, one of the most effective therapies to improve glycemic control, is often delayed due to fear of hypoglycemia; also once premixed insulin therapy is begun, oral medications are commonly discontinued.
"Insulin is a powerful treatment for achieving the kind of glycemic control that reduces diabetic complications for the millions of people with type 2 diabetes around the world, but too many patients remain at risk from poorly controlled blood glucose," Matthias-Axel Schweitzer from the Medical Department of Aventis in Germany said adding that Lantus offers an effective and safe option for initiation of insulin therapy, and compares favourably to premixed 70 per cent NPH and 30 per cent regular insulins.
A1C, also referred to as glycated hemoglobin or HbA1c, is a measure of the average blood glucose level over a two- to three-month period and is the preferred standard blood test for assessing and monitoring glucose control in people with type 1 and type 2 diabetes. The American Diabetes Association recommends that patients withdiabetesachievean A1C<7 per cent for optimal diabetes control. Prominent landmark studies - the United Kingdom Prospective Diabetes Study (UKPDS) and the Diabetes Complications and Control Trial (DCCT) - have shown that reduction in A1C is associated with a reduced risk for microvascular complications (small blood vessel complications that result in eye, kidney and nerve damage). Other expert organizations, including the International Diabetes Federation, recommend an even tightergoalofA1C<6.5 per cent.