title: [Clinical experiences with basal analogue insulin in routine care. Retrospective follow up analysis of a database from daily routine care].
abstract: BACKGROUND
  Basal-bolus insulin regime is frequently used in type 2 diabetes in order to improve metabolic control and decrease the risk of complications. A general question is, however, the effect of application of analogue insulin in comparison to human insulin regimes.
  
  
  OBJECTIVE
  The aim of the authors was to perform a retrospective database analysis among patients who were switched from human insulin only based basal-bolus regime to analogue only insulin regime in order to examine changes in metabolic control, body weight, insulin dose and basal:bolus insulin ratio.
  
  
  METHODS
  Type 2 diabetic patients (n = 137) were enrolled who used once daily basal insulin with complementary bolus insulin given at main meals, and human insulin was switched to analogue insulin. Patients were divided into two groups using detemir (n = 103) or glargine (n = 34).
  
  
  RESULTS
  During 17 months of analogue insulin treatment the HbA1c was decreased by 0.34% (detemir -0.44%; glargine -0.17%). Body weight was increased by 1.11 kg (detemir +1.0 kg; glargine +1.43 kg). The basal:bolus insulin ratio increased in all groups (entire cohort 6.04%, detemir 5.26%, glargine 8.37%). The average insulin dose was 80.76 units at the end of follow up. There was no significant difference in terms of total and basal insulin doses between detemir (27.89 and 79.78 U, respectively) and glargine group (32.85 and 83.74 U, respectively).
  
  
  CONCLUSIONS
  These results support that switching from human to analogue insulin in basal-bolus regime could improve the metabolic control by increasing dose of basal analogue insulin and basal: bolus ratio. Both detemir and glargine can provide similar improvement in metabolic control with the same insulin dose but with relatively more weight gain with glargine.
authors.affiliation: Tolna Megyei Balassa János Kórház III. Belgyógyászat és Diabetes Szakrendelés Szekszárd Béri B. Á. u. 5-7. 7100.
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Sudár
authors.forename: Lajos
authors.initials: L
authors.lastname: Muth
authors.forename: Csaba
authors.initials: C
authors.lastname: Nyirati
authors.forename: Vince
authors.initials: V
authors.lastname: Szí
authors.forename: János
authors.initials: J
authors.lastname: Tornóczky
authors.forename: Gabriella
authors.initials: G
authors.lastname: Ulrich
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016208:Databases, Factual; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D000069057:Insulin Detemir; D000069036:Insulin Glargine; D049528:Insulin, Long-Acting / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D015430:Weight Gain / Q000187:drug effects
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D000069057:Insulin Detemir; D000069036:Insulin Glargine; D049528:Insulin, Long-Acting; C517652:hemoglobin A1c protein, human