title: An increased dose of insulin detemir improves glycaemic control and reduces body weight of Japanese patients with diabetes.
abstract: OBJECTIVE
  The aim of study was to evaluate the safety and efficacy of insulin detemir as a basal insulin switching from neutral protamine Hagedorn insulin (NPH) and insulin glargine in patients with diabetes on an intensive insulin therapy regimen.
  
  
  METHODS
  This 6-month multicentre, prospective, treat-to-target [glycosylated haemoglobin (HbA(1c) ) less than 6.5%] trial included 92 people with diabetes (61 type 1, 29 type 2 and two unknown diabetes types). Detemir was administered first with fixed dose and injection times and then adapted to optimal dose after 3 months.
  
  
  RESULTS
  Mean HbA(1c) (%) of all the subjects at months 4 to 6 of the study was improved compared with month 0 (7.34 ± 0.87, 7.28 ± 0.88, 7.25 ± 0.93 vs. 7.55 ± 1.18; p < 0.05 paired t-test). However, significant improvement was seen only among the patients who had previously used NPH as a basal insulin. Twice-daily injection of basal insulin increased among people in the type 1 previously injected insulin glargine. Total insulin dose increased in the type 1 glargine group. The mean body weight change in the highest quartile body mass index (BMI) group was from 70.7 to 69.3 kg over the 6 months. Quality of life (QoL) relating to the patients' glycaemic control tended to improve without a change in frequency of hypoglycaemia.
  
  
  CONCLUSIONS
  The results suggest that insulin detemir has a greater effect on glycaemic control in subjects with poor glycaemic control using NPH; can reduce or maintain body weight in obese patients; and obtains perceptive stability for patients with unstable glycaemic control.
authors.affiliation: Tama-center Mirai Clinic, Ochiai, Tama-city, Tokyo, JapanTokyo Medical University Hachioji Medical Center, Ochiai, Tama-city, Tokyo, JapanKato Clinic, Ochiai, Tama-city, Tokyo, JapanKondo Clinic, Ochiai, Tama-city, Tokyo, JapanTakamura Clinic, Ochiai, Tama-city, Tokyo, JapanTakesue Clinic, Ochiai, Tama-city, Tokyo, JapanHaru Clinic, Ochiai, Tama-city, Tokyo, JapanHigashiYamato Hospital, Ochiai, Tama-city, Tokyo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Fujii
authors.affiliation: Tama-center Mirai Clinic, Ochiai, Tama-city, Tokyo, JapanTokyo Medical University Hachioji Medical Center, Ochiai, Tama-city, Tokyo, JapanKato Clinic, Ochiai, Tama-city, Tokyo, JapanKondo Clinic, Ochiai, Tama-city, Tokyo, JapanTakamura Clinic, Ochiai, Tama-city, Tokyo, JapanTakesue Clinic, Ochiai, Tama-city, Tokyo, JapanHaru Clinic, Ochiai, Tama-city, Tokyo, JapanHigashiYamato Hospital, Ochiai, Tama-city, Tokyo, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Watanabe
authors.affiliation: Tama-center Mirai Clinic, Ochiai, Tama-city, Tokyo, JapanTokyo Medical University Hachioji Medical Center, Ochiai, Tama-city, Tokyo, JapanKato Clinic, Ochiai, Tama-city, Tokyo, JapanKondo Clinic, Ochiai, Tama-city, Tokyo, JapanTakamura Clinic, Ochiai, Tama-city, Tokyo, JapanTakesue Clinic, Ochiai, Tama-city, Tokyo, JapanHaru Clinic, Ochiai, Tama-city, Tokyo, JapanHigashiYamato Hospital, Ochiai, Tama-city, Tokyo, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Ueki
authors.affiliation: Tama-center Mirai Clinic, Ochiai, Tama-city, Tokyo, JapanTokyo Medical University Hachioji Medical Center, Ochiai, Tama-city, Tokyo, JapanKato Clinic, Ochiai, Tama-city, Tokyo, JapanKondo Clinic, Ochiai, Tama-city, Tokyo, JapanTakamura Clinic, Ochiai, Tama-city, Tokyo, JapanTakesue Clinic, Ochiai, Tama-city, Tokyo, JapanHaru Clinic, Ochiai, Tama-city, Tokyo, JapanHigashiYamato Hospital, Ochiai, Tama-city, Tokyo, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Ohno
authors.affiliation: Tama-center Mirai Clinic, Ochiai, Tama-city, Tokyo, JapanTokyo Medical University Hachioji Medical Center, Ochiai, Tama-city, Tokyo, JapanKato Clinic, Ochiai, Tama-city, Tokyo, JapanKondo Clinic, Ochiai, Tama-city, Tokyo, JapanTakamura Clinic, Ochiai, Tama-city, Tokyo, JapanTakesue Clinic, Ochiai, Tama-city, Tokyo, JapanHaru Clinic, Ochiai, Tama-city, Tokyo, JapanHigashiYamato Hospital, Ochiai, Tama-city, Tokyo, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Kato
authors.affiliation: Tama-center Mirai Clinic, Ochiai, Tama-city, Tokyo, JapanTokyo Medical University Hachioji Medical Center, Ochiai, Tama-city, Tokyo, JapanKato Clinic, Ochiai, Tama-city, Tokyo, JapanKondo Clinic, Ochiai, Tama-city, Tokyo, JapanTakamura Clinic, Ochiai, Tama-city, Tokyo, JapanTakesue Clinic, Ochiai, Tama-city, Tokyo, JapanHaru Clinic, Ochiai, Tama-city, Tokyo, JapanHigashiYamato Hospital, Ochiai, Tama-city, Tokyo, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Kondo
authors.affiliation: Tama-center Mirai Clinic, Ochiai, Tama-city, Tokyo, JapanTokyo Medical University Hachioji Medical Center, Ochiai, Tama-city, Tokyo, JapanKato Clinic, Ochiai, Tama-city, Tokyo, JapanKondo Clinic, Ochiai, Tama-city, Tokyo, JapanTakamura Clinic, Ochiai, Tama-city, Tokyo, JapanTakesue Clinic, Ochiai, Tama-city, Tokyo, JapanHaru Clinic, Ochiai, Tama-city, Tokyo, JapanHigashiYamato Hospital, Ochiai, Tama-city, Tokyo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Takamura
authors.affiliation: Tama-center Mirai Clinic, Ochiai, Tama-city, Tokyo, JapanTokyo Medical University Hachioji Medical Center, Ochiai, Tama-city, Tokyo, JapanKato Clinic, Ochiai, Tama-city, Tokyo, JapanKondo Clinic, Ochiai, Tama-city, Tokyo, JapanTakamura Clinic, Ochiai, Tama-city, Tokyo, JapanTakesue Clinic, Ochiai, Tama-city, Tokyo, JapanHaru Clinic, Ochiai, Tama-city, Tokyo, JapanHigashiYamato Hospital, Ochiai, Tama-city, Tokyo, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Takesue
authors.affiliation: Tama-center Mirai Clinic, Ochiai, Tama-city, Tokyo, JapanTokyo Medical University Hachioji Medical Center, Ochiai, Tama-city, Tokyo, JapanKato Clinic, Ochiai, Tama-city, Tokyo, JapanKondo Clinic, Ochiai, Tama-city, Tokyo, JapanTakamura Clinic, Ochiai, Tama-city, Tokyo, JapanTakesue Clinic, Ochiai, Tama-city, Tokyo, JapanHaru Clinic, Ochiai, Tama-city, Tokyo, JapanHigashiYamato Hospital, Ochiai, Tama-city, Tokyo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Nishimura
authors.affiliation: Tama-center Mirai Clinic, Ochiai, Tama-city, Tokyo, JapanTokyo Medical University Hachioji Medical Center, Ochiai, Tama-city, Tokyo, JapanKato Clinic, Ochiai, Tama-city, Tokyo, JapanKondo Clinic, Ochiai, Tama-city, Tokyo, JapanTakamura Clinic, Ochiai, Tama-city, Tokyo, JapanTakesue Clinic, Ochiai, Tama-city, Tokyo, JapanHaru Clinic, Ochiai, Tama-city, Tokyo, JapanHigashiYamato Hospital, Ochiai, Tama-city, Tokyo, Japan.
authors.forename: D
authors.initials: D
authors.lastname: Matsuda
authors.affiliation: Tama-center Mirai Clinic, Ochiai, Tama-city, Tokyo, JapanTokyo Medical University Hachioji Medical Center, Ochiai, Tama-city, Tokyo, JapanKato Clinic, Ochiai, Tama-city, Tokyo, JapanKondo Clinic, Ochiai, Tama-city, Tokyo, JapanTakamura Clinic, Ochiai, Tama-city, Tokyo, JapanTakesue Clinic, Ochiai, Tama-city, Tokyo, JapanHaru Clinic, Ochiai, Tama-city, Tokyo, JapanHigashiYamato Hospital, Ochiai, Tama-city, Tokyo, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Miyakawa
mesh_terms: D000328:Adult; D000368:Aged; D019440:Anti-Obesity Agents / Q000627:therapeutic use; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D000069057:Insulin Detemir; D000069036:Insulin Glargine; D007336:Insulin, Isophane / Q000008:administration & dosage; D049528:Insulin, Long-Acting / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000517:prevention & control; D011446:Prospective Studies; D016896:Treatment Outcome; D015431:Weight Loss / Q000187:drug effects*
chemical_list: D019440:Anti-Obesity Agents; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D000069057:Insulin Detemir; D000069036:Insulin Glargine; D007336:Insulin, Isophane; D049528:Insulin, Long-Acting