title: Comparison of the Efficacy and Safety of Insulin Detemir and Insulin Glargine in Hospitalized Patients with Type 2 Diabetes: A Randomized Crossover Trial.
abstract: BACKGROUND
  Previous studies comparing insulin detemir versus insulin glargine showed conflicting results, and included only outpatients. This study compared the two insulin analogs once daily in hospitalized patients with type 2 diabetes (T2D).
  
  
  METHODS
  A total of 55 patients aged 18-80 years with hyperglycemia admitted to the endocrinology wards were screened between June 2014 and February 2015. Forty-two enrolled patients were randomly assigned to receive either insulin detemir followed by insulin glargine once daily (n = 21), or vice versa (n = 21). The two insulin analogs were titrated 0.1 U/kg once daily based on fasting blood glucose (FBG). After achieving FBG <7.8 mmol/L (the first period), subjects were switched from one analog to the other (the second period) with no change in the dose. The second period lasted for 3 days. When hypoglycemia occurred in the second period, the observation was discontinued. Six-point blood glucose including FBG, 2 h after breakfast, lunch, dinner, bedtime, and at 3:00 am was tested every day. The glucose profiles of the final days in the two periods were compared.
  
  
  RESULTS
  At the end of the first period, days for achieving FBG target (4.0 ± 0.5 days vs. 3.3 ± 0.4 days, t = 1.079, P = 0.286) and total daily dose (30.1 ± 2.4 U vs. 30.1 ± 2.9 U, t = 0.002, P = 0.999) between insulin detemir and insulin glargine were similar. There was no significant difference in the 24-h glucose control between the two analogs. No hypoglycemia occurred with both analogs in the first period. However, in the second period, when insulin glargine was switched to insulin detemir, two, three and, one patients had hypoglycemia events on day 1, day 2 and day 3 of the second period, respectively. One patient had severe hypoglycemia on day 1.
  
  
  CONCLUSIONS
  When both basal insulin analogs were given once daily in T2D, insulin detemir achieved similar efficacy to insulin glargine. On the other hand, there may be differences in action of the compared basal insulins. Further studies with larger patient samples are necessary to support evidence and reveal possible mechanisms.
authors.affiliation: Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China.
authors.forename: Tong
authors.initials: T
authors.lastname: Zhang
authors.affiliation: Department of Endocrinology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
authors.forename: Mingrun
authors.initials: M
authors.lastname: Lin
authors.affiliation: Department of Endocrinology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. liwg660@126.com.
authors.forename: Wangen
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Endocrinology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
authors.forename: Xiuyun
authors.initials: X
authors.lastname: Fan
authors.affiliation: Department of Endocrinology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Du
authors.affiliation: Department of Endocrinology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
authors.forename: Yunjuan
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Department of Endocrinology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
authors.forename: Xiaodan
authors.initials: X
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D006760:Hospitalization; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy; D007003:Hypoglycemia / Q000139:chemically induced; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000069057:Insulin Detemir / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000069036:Insulin Glargine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D000069036:Insulin Glargine; D000069057:Insulin Detemir
keywords: Endocrinology; Hyperglycemia; Insulin detemir; Insulin glargine; Type 2 diabetes