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Diabetes Res Clin Pract. 2012 Apr;96(1):17-23. doi: 10.1016/j.diabres.2011.10.046. Epub 2011 Dec 1.

Insulin analogues and severe hypoglycaemia in type 1 diabetes.

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1
Steno Diabetes Center, Niels Steensens Vej 2, Gentofte, Denmark.

Abstract

INTRODUCTION:

The effect of insulin analogues on glycaemic control is well-documented, whereas the effect on avoidance of severe hypoglycaemia remains tentative. We studied the frequency of severe hypoglycaemia in unselected patients with type 1 diabetes treated with insulin analogues, human insulin, or mixed regimens.

METHODS:

A questionnaire was posted from six Danish diabetes clinics to 6112 unselected patients with type 1 diabetes and filled in by 3861 patients (63.2%). Primary endpoint was number of episodes of severe hypoglycaemia in the preceding year. Mild hypoglycaemia was also reported.

RESULTS:

The frequency of severe hypoglycaemic episodes per patient-year in patients receiving long-acting insulin analogues was 1.47±0.18 versus 1.09±0.10 in patients on long-acting human insulin (p=0.01). The frequency of severe hypoglycaemic episodes per patient-year was 1.09±0.11 in patients on short-acting insulin analogues versus 1.26±0.13 in patients on short-acting human insulin (p=0.15), which was statistically significant in an adjusted analysis.

CONCLUSIONS:

Severe hypoglycaemia is more frequent in patients with type 1 diabetes treated with long-acting insulin analogues. Confounding by indication may be involved. Clinical intervention trials using insulin analogues in patients prone to severe hypoglycaemia are highly needed.

PMID:
22136722
DOI:
10.1016/j.diabres.2011.10.046
[Indexed for MEDLINE]
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