title: Efficacy and acceptance of two intensified conventional insulin therapy regimens: a long-term cross-over comparison.
abstract: The efficacy and acceptability of multiple daily insulin injections (three preprandial injections of short-acting insulin (NovoPen) plus once daily extended-acting insulin) were compared with those of twice daily injections of short- and intermediate-acting insulin. Sixteen Type 1 diabetic patients participated in a cross-over study (6-month treatment periods). Total areas under 24-h plasma free insulin curves, assessed at the end of each study period, were not significantly different, but a greater area under this curve was found for the pen-injector regimen from 1200 to 1600 h (150 +/- 15 (SE) vs 106 +/- 7 mU l-1 h, p less than 0.01). Home blood glucose profiles showed significantly lower values with pen-injector therapy after lunch (7.1 +/- 0.6 vs 8.4 +/- 0.4 mmol l-1, p = 0.05) and before and after dinner (6.4 +/- 0.6 vs 8.8 +/- 0.5 mmol l-1, p less than 0.005, and 7.5 +/- 0.7 vs 9.4 +/- 1.1 mmol l-1, p less than 0.05). Mean daily blood glucose concentration was also lower (7.1 +/- 0.4 vs 8.2 +/- 0.5 mmol l-1, p less than 0.05). HbA1, fructosamine, hypoglycaemic reactions, and body weight were not significantly different. Thirteen patients decided to continue with pen-injector therapy at the end of the study.
authors.affiliation: Department of Internal Medicine, Free University Hospital, Amsterdam, The Netherlands.
authors.forename: C M
authors.initials: CM
authors.lastname: Houtzagers
authors.forename: P A
authors.initials: PA
authors.lastname: Berntzen
authors.forename: H
authors.initials: H
authors.lastname: van der Stap
authors.forename: W W
authors.initials: WW
authors.lastname: van Maarschalkerweerd
authors.forename: P
authors.initials: P
authors.lastname: Lanting
authors.forename: I
authors.initials: I
authors.lastname: Boen-Tan
authors.forename: R J
authors.initials: RJ
authors.lastname: Heine
authors.forename: E A
authors.initials: EA
authors.lastname: van der Veen
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002986:Clinical Trials as Topic; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy*; D004334:Drug Administration Schedule; D004435:Eating; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007328:Insulin / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin