An increased dose of insulin detemir improves glycaemic control and reduces body weight of Japanese patients with diabetes.
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.
Fujii
H
H
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.
Watanabe
Y
Y
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.
Ueki
A
A
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.
Ohno
A
A
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.
Kato
M
M
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.
Kondo
K
K
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.
Takamura
H
H
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.
Takesue
M
M
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.
Nishimura
H
H
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.
Matsuda
D
D
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.
Miyakawa
T
T
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.
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*
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