An analysis of dosing equivalence of insulin detemir and insulin glargine: more evidence?
Current guidelines for the management of type 2 diabetes call for the use of basal insulin when glycemic targets are not achieved. Previous studies have demonstrated noninferiority of insulin detemir, dosed once or twice daily, and insulin glargine, dosed once daily. In this issue of Journal of Diabetes Science and Technology, Dr. Allen King provides additional data of his previously published randomized, double-blinded, crossover trial in which both insulins were restricted to once-daily use. In this trial of 29 patients, 24-hour continuous glucose monitoring profiles (published previously) and dosing requirements (in this publication) were shown to be statistically equivalent between the two insulins. The shortcomings of this trial are its short duration, small number of patients, and potential interference from endogenous insulin. Longer trials with more patients, studying once-daily use of these medications, will help better determine if any significant differences exist.
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Mark W
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Diabetes Center of Excellence, Wilford Hall Medical Center, Lackland Air Force Base, Texas, USA. mark.true@us.af.mil
D001786:Blood Glucose / Q000032:analysis; D002940:Circadian Rhythm; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D054796:Drug Dosage Calculations; D019317:Evidence-Based Medicine; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007206:Individuality; D007328:Insulin / Q000008:administration & dosage / Q000031:analogs & derivatives*; D000069057:Insulin Detemir; D000069036:Insulin Glargine; D049528:Insulin, Long-Acting; D016032:Randomized Controlled Trials as Topic; D013810:Therapeutic Equivalency
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D049528:Insulin, Long-Acting; D000069036:Insulin Glargine; D000069057:Insulin Detemir