A comparative study of once daily insulin injection regimes in the treatment of elderly diabetics.
A randomised crossover trial of Insulatard, Lentard and Mixtard insulins as once daily therapy was undertaken in 10 diabetics who had been on long term insulin and in 7 patients who were poorly controlled on oral hypoglycaemic agents and had not previously received insulin. The glycaemic control of those patients with prior insulin therapy was very similar under these 3 insulin regimes. In patients previously on oral hypoglycaemic agents the mean (+/- SEM) blood glucose (10.0 +/- 0.8 mmol/l), log "M" value (1.78 +/- 0.10) and area under the glucose curve (192 +/- 16 mmol . hr/l) were all lower on Insulatard than when on Lentard (13.0 +/- 0.9, 2.03 +/- 0.08 and 258 +/- 17 respectively; p less than 0.05 in each case). Mixtard values were intermediate (11.2 +/- 1.3, 1.83 +/- 0.19 and 258 +/- 17). Furthermore blood glucose values were within the physiological range of 3-7 mmol/l in 20% of patients on Insulatard, in 16% on Mixtard but in only 2% on Lentard. Significant hypoglycaemia (blood glucose less than 3 mmol/l) in both groups of patients was noted more commonly with Mixtard (7 episodes) than with Lentard (3 episodes) or Insulatard (2 episodes). There was no significant difference in the free insulin levels between these insulin regimes but mean log total insulin levels were higher (p less than 0.005) when the patients were taking Lentard (2.33 +/- 0.13) in comparison with both Insulatard (1.99 +/- 0.14) and Mixtard (1.92 +/- 0.13). The mean insulin binding rose 4.9% during Lentard treatment and fell slightly by 0.6% on Insulatard and 0.9% on Mixtard (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
Roland
J M
JM
Lewin
I G
IG
O'Brien
I A
IA
Markanday
S
S
Kurtz
A B
AB
Corrall
R J
RJ
D000368:Aged; D000906:Antibodies / Q000032:analysis; D001786:Blood Glucose / Q000032:analysis; D003920:Diabetes Mellitus / Q000188:drug therapy*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007328:Insulin / Q000008:administration & dosage* / Q000097:blood / Q000276:immunology; D008297:Male; D008875:Middle Aged
D000906:Antibodies; D001786:Blood Glucose; D007328:Insulin