ArticleCardiovascular diabetology2009
Improved glycaemic control by switching from insulin NPH to insulin glargine: a retrospective observational study.
Article in Cardiovascular diabetology, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Are analogue insulins superior to human insulin in clinical practice?Current diabetes reports · 2010Pooled it
- Insulin therapy in type 2 diabetes: Insights into clinical efficacy, patient-reported outcomes, and adherence challenges.World journal of diabetes · 2024Review
- The Comparative Dosing and Glycemic Control of Intermediate and Long-Acting Insulins in Adult Patients With Type 1 and 2 Diabetes Mellitus.The Journal of pharmacy technology : jPT : official publication of the Association of Pharmacy Technicians · 2022Review
- A European, multicentre, retrospective, non-interventional study (EU-TREAT) of the effectiveness of insulin degludec after switching basal insulin in a population with type 1 or type 2 diabetes.Diabetes, obesity & metabolism · 2018Observational
- A comparison of methods for estimating the temporal change in a continuous variable: Example of HbA1c in patients with diabetes.Pharmacoepidemiology and drug safety · 2017Article
- Improved Glycemic Control Achieved by Switching to Insulin Degludec in Insulin-Treated Patients with Type 2 Diabetes in a Real-World Setting: a Non-interventional, Retrospective Cohort Study.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2017Article
- Metabolic effects of Basal or premixed insulin treatment in 5077 insulin-naïve type 2 diabetes patients: registry-based observational study in clinical practice.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2014Article
- A propensity score matched comparison of different insulin regimens 1 year after beginning insulin in people with type 2 diabetes.Diabetes, obesity & metabolism · 2013Observational
- Outcomes with insulin glargine in patients with type 2 diabetes previously on NPH insulin: evidence from clinical practice in Spain.International journal of clinical practice · 2012Article
- Clinical experience with insulin glargine in type 1 diabetes.Diabetes technology & therapeutics · 2010Review
- A comparison of intermediate and long-acting insulins in people with type 2 diabetes starting insulin: an observational database study.International journal of clinical practice · 2010Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInsulin glargine (glargine) and insulin NPH (NPH) are two basal insulin treatments. This study investigated the effect on glycaemic control of switching from a NPH-based regimen to a glargine-based regimen in 701 patients with type 1 (n= 304) or type 2 (n= 397) diabetes, using unselected primary care data.
methodsData for this retrospective observational study were extracted from a UK primary care database (The Health Improvement Network). Patients were required to have at least 12 months of data before and after switching from NPH to glargine. The principal analysis was the change in HbA(1c) after 12 months treatment with glargine; secondary analyses included change in weight and total daily insulin dose. Inconsistent reporting of hypoglycemic episodes precludes reliable reporting of this outcome. Multivariate analyses were used to adjust for baseline characteristics and confounding variables.
resultsAfter adjustment, both diabetic cohorts showed statistically significant reductions in mean HbA(1c) 12 months after the switch, by 0.38% (p < 0.001) in type 1 patients and 0.31% (p < 0.001) in type 2 patients. Improvement in HbA1c was positively correlated with baseline HbA(1c); patients with baseline HbA(1c) > or = 8% had reductions of 0.57% (p < 0.001) and 0.47% (p < 0.001), respectively. There was no significant change in weight or total daily insulin dose while on glargine. The majority of patients received a basal-bolus regimen prior to and after the switch (mean 79.3% before and 77.2% after switch in type 1 patients, and 80.4% and 76.8%, respectively in type 2 patients, p > 0.05).
conclusionIn routine clinical practice, switching from NPH to glargine provides the opportunity for improving glycaemic control in diabetes patients inadequately controlled by NPH.
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