title: Efficacy of long-acting insulin analog insulin glargine at high dosage for basal-bolus insulin therapy in patients with type 2 diabetes.
abstract: OBJECTIVE
  Attempts to achieve strict glycemic control with basal-bolus insulin therapy required increased dosages of neutral protamine Hagedorn (NPH) insulin. However, high dosage of NPH insulin often occurs nocturnal hypoglycemia. Insulin glargine can simulate normal basal insulin secretion with its flat time-action profiles. To confirm the efficacy of insulin glargine we investigated the type 2 diabetic patients on basal-bolus insulin therapy whose basal insulin was switched from NPH insulin to insulin glargine.
  
  
  METHODS
  The Japanese 400 patients with type 2 diabetes on basal-bolus insulin therapy whose basal insulin was switched from NPH insulin to insulin glargine were followed-up. After the switching, the basal insulin was increased with reference to the self-monitoring of blood glucose results, with the aim of maintaining fasting blood sugar (FBS) level at 110 mg/dL, and simultaneously reducing the bolus insulin dosage to maintain the total daily insulin dosage.
  
  
  RESULTS
  We were able to lower FBS significantly with almost no serious hypoglycemia. HbA1c also improved significantly. The improvements in FBS and HbA1c levels did not require a significant increase in the total insulin dosage.
  
  
  CONCLUSIONS
  Our results suggest that basal insulin supplementation using insulin glargine is a useful method to control not only FBS but also HbA1c.
authors: Division of Nephrology and Metabolism, Department of Internal Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193 Japan. daisuke@is.icc.u-tokai.ac.jp
authors: Daisuke
authors: D
authors: Suzuki
authors: Masao
authors: M
authors: Toyoda
authors: Masumi
authors: M
authors: Kondo
authors: Han
authors: H
authors: Miyatake
authors: Eitaro
authors: E
authors: Tanaka
authors: Hiroki
authors: H
authors: Sato
authors: Yusuke
authors: Y
authors: Kuriyama
authors: Masaaki
authors: M
authors: Miyauchi
authors: Naoyuki
authors: N
authors: Yamamoto
authors: Moritsugu
authors: M
authors: Kimura
authors: Tomoya
authors: T
authors: Umezono
authors: Masafumi
authors: M
authors: Fukagawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D000069036:Insulin Glargine; D049528:Insulin, Long-Acting / Q000008:administration & dosage*; D007564:Japan; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D000069036:Insulin Glargine; D049528:Insulin, Long-Acting; C517652:hemoglobin A1c protein, human