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Insulin glargine effectively achieves glycemic control and improves insulin resistance in patients with early type 2 diabetes that exhibit a high risk for cardiovascular disease.

Li J, Feng Z, Li Q, He Y, Zhao C, He J - Exp Ther Med (2014)

Bottom Line: The fasting plasma glucose level in the insulin-glargine group was significantly lower than that observed in the standard-care group.Although the level of the HOMA-β did not differ between the two groups, the level of HOMA-IR in the insulin-glargine group was significantly lower than that observed in the standard-care group.During the follow-up period, the incidence of hypoglycemia in the insulin-glargine group was significantly higher when compared with the standard-care group, however, no significant difference in the incidence of adverse cardiovascular events was observed.

View Article: PubMed Central - PubMed

Affiliation: Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, P.R. China.

ABSTRACT
In the present study, the clinical efficacy and safety of administering insulin glargine to early type 2 diabetes (T2D) mellitus patients with a high risk for cardiovascular disease were assessed. A total of 42 early T2D patients at a high risk for cardiovascular disease were randomly divided into an insulin-glargine group and a standard-care group. The patients in the insulin-glargine group received oral antidiabetic agents plus glargine once a day via a subcutaneous injection. The patients in the standard-care group were administered oral antidiabetic agents according to the diabetic treatment guidelines. The median follow-up period was 6.4 years. Comparisons were made between the two groups with regard to levels of plasma glucose, glycosylated hemoglobin (HbA1c) and plasma lipids, the homeostasis model assessment-insulin secretion index (HOMA-β) and HOMA-insulin resistance index (HOMA-IR), as well as the incidence of hypoglycemia, adverse cardiovascular events and body mass index (BMI). The fasting plasma glucose level in the insulin-glargine group was significantly lower than that observed in the standard-care group. However, the levels of 2-h postprandial glucose, HbA1c and plasma lipids, as well as the BMI, were similar when comparing the two groups. Although the level of the HOMA-β did not differ between the two groups, the level of HOMA-IR in the insulin-glargine group was significantly lower than that observed in the standard-care group. During the follow-up period, the incidence of hypoglycemia in the insulin-glargine group was significantly higher when compared with the standard-care group, however, no significant difference in the incidence of adverse cardiovascular events was observed. Therefore, the results of the present study indicated that insulin glargine may effectively achieve glycemic control and improve insulin resistance without increasing the risk for cardiovascular events in early T2D patients that were considered to be at a high risk for cardiovascular disease.

No MeSH data available.


Related in: MedlinePlus

Changes in the FPG levels in the two groups between the baseline and the study endpoint. FPG levels were determined at the beginning of the study and at the final follow-up examination using a glucose oxidase assay. The mean FPG level in the insulin-glargine group changed significantly between the baseline and the endpoint. *P<0.01, vs. baseline; #P<0.05, vs. standard-care group. FPG, fasting plasma glucose.
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f3-etm-08-01-0147: Changes in the FPG levels in the two groups between the baseline and the study endpoint. FPG levels were determined at the beginning of the study and at the final follow-up examination using a glucose oxidase assay. The mean FPG level in the insulin-glargine group changed significantly between the baseline and the endpoint. *P<0.01, vs. baseline; #P<0.05, vs. standard-care group. FPG, fasting plasma glucose.

Mentions: The baseline characteristics of the subjects are shown in Table I. Overall, the baseline demographics were considered to be relatively uniform between the two groups (P>0.05). To measure the levels of FPG, HbA1c and 2hPG, a glucose oxidase assay and high performance liquid chromatography were conducted. Following treatment, the mean FPG level in the insulin-glargine group demonstrated a constant overall reduction from 7.07 to 5.79 mmol/l over the 6.4-year treatment period (P<0.01; Fig. 1), however, the mean HbA1c level did not alter significantly (Table II and Fig. 2). By contrast, the FPG and HbA1c levels in the standard-care group did not indicate a significant difference prior to and following treatment (Figs. 1 and 2). Through comparing the data at the endpoints between the two groups, it was identified that the FPG level in the insulin-glargine group (5.79±0.83 mmol/l) was significantly lower than the level in the standard-care group (7.17±1.77 mmol/l; P<0.05), however, the levels of HbA1c and 2hPG did not differ between the two groups (Table III and Fig. 3). In addition, the FPG level in the insulin-glargine group was significantly lower than the level observed in the standard-care group during the follow-up period (P<0.05; Table II and Fig. 1). These observations indicated that insulin glargine treatment influenced the reduction in FPG levels, but exhibited no effect on the levels of HbA1c or 2hPG.


Insulin glargine effectively achieves glycemic control and improves insulin resistance in patients with early type 2 diabetes that exhibit a high risk for cardiovascular disease.

Li J, Feng Z, Li Q, He Y, Zhao C, He J - Exp Ther Med (2014)

Changes in the FPG levels in the two groups between the baseline and the study endpoint. FPG levels were determined at the beginning of the study and at the final follow-up examination using a glucose oxidase assay. The mean FPG level in the insulin-glargine group changed significantly between the baseline and the endpoint. *P<0.01, vs. baseline; #P<0.05, vs. standard-care group. FPG, fasting plasma glucose.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4061209&req=5

f3-etm-08-01-0147: Changes in the FPG levels in the two groups between the baseline and the study endpoint. FPG levels were determined at the beginning of the study and at the final follow-up examination using a glucose oxidase assay. The mean FPG level in the insulin-glargine group changed significantly between the baseline and the endpoint. *P<0.01, vs. baseline; #P<0.05, vs. standard-care group. FPG, fasting plasma glucose.
Mentions: The baseline characteristics of the subjects are shown in Table I. Overall, the baseline demographics were considered to be relatively uniform between the two groups (P>0.05). To measure the levels of FPG, HbA1c and 2hPG, a glucose oxidase assay and high performance liquid chromatography were conducted. Following treatment, the mean FPG level in the insulin-glargine group demonstrated a constant overall reduction from 7.07 to 5.79 mmol/l over the 6.4-year treatment period (P<0.01; Fig. 1), however, the mean HbA1c level did not alter significantly (Table II and Fig. 2). By contrast, the FPG and HbA1c levels in the standard-care group did not indicate a significant difference prior to and following treatment (Figs. 1 and 2). Through comparing the data at the endpoints between the two groups, it was identified that the FPG level in the insulin-glargine group (5.79±0.83 mmol/l) was significantly lower than the level in the standard-care group (7.17±1.77 mmol/l; P<0.05), however, the levels of HbA1c and 2hPG did not differ between the two groups (Table III and Fig. 3). In addition, the FPG level in the insulin-glargine group was significantly lower than the level observed in the standard-care group during the follow-up period (P<0.05; Table II and Fig. 1). These observations indicated that insulin glargine treatment influenced the reduction in FPG levels, but exhibited no effect on the levels of HbA1c or 2hPG.

Bottom Line: The fasting plasma glucose level in the insulin-glargine group was significantly lower than that observed in the standard-care group.Although the level of the HOMA-β did not differ between the two groups, the level of HOMA-IR in the insulin-glargine group was significantly lower than that observed in the standard-care group.During the follow-up period, the incidence of hypoglycemia in the insulin-glargine group was significantly higher when compared with the standard-care group, however, no significant difference in the incidence of adverse cardiovascular events was observed.

View Article: PubMed Central - PubMed

Affiliation: Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, P.R. China.

ABSTRACT
In the present study, the clinical efficacy and safety of administering insulin glargine to early type 2 diabetes (T2D) mellitus patients with a high risk for cardiovascular disease were assessed. A total of 42 early T2D patients at a high risk for cardiovascular disease were randomly divided into an insulin-glargine group and a standard-care group. The patients in the insulin-glargine group received oral antidiabetic agents plus glargine once a day via a subcutaneous injection. The patients in the standard-care group were administered oral antidiabetic agents according to the diabetic treatment guidelines. The median follow-up period was 6.4 years. Comparisons were made between the two groups with regard to levels of plasma glucose, glycosylated hemoglobin (HbA1c) and plasma lipids, the homeostasis model assessment-insulin secretion index (HOMA-β) and HOMA-insulin resistance index (HOMA-IR), as well as the incidence of hypoglycemia, adverse cardiovascular events and body mass index (BMI). The fasting plasma glucose level in the insulin-glargine group was significantly lower than that observed in the standard-care group. However, the levels of 2-h postprandial glucose, HbA1c and plasma lipids, as well as the BMI, were similar when comparing the two groups. Although the level of the HOMA-β did not differ between the two groups, the level of HOMA-IR in the insulin-glargine group was significantly lower than that observed in the standard-care group. During the follow-up period, the incidence of hypoglycemia in the insulin-glargine group was significantly higher when compared with the standard-care group, however, no significant difference in the incidence of adverse cardiovascular events was observed. Therefore, the results of the present study indicated that insulin glargine may effectively achieve glycemic control and improve insulin resistance without increasing the risk for cardiovascular events in early T2D patients that were considered to be at a high risk for cardiovascular disease.

No MeSH data available.


Related in: MedlinePlus