Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2007) 14 P37

ECE2007 Poster Presentations (1) (659 abstracts)

One injection of Detemir insulin administered before the lunch improves the metabolic control in type 1 diabetic patients

Juan Carlos Ferrer-García 1 , Juan Francisco Merino-Torres 2 , Raquel Segovia-Portolés 2 , Vicente Campos-Alborg 2 , Agustín Herrera Ballester 1 , Francisco Piñón Sellés 2 & Carlos Sánchez Juan 1

1University General Hospital, Valencia, Spain; 2University Hospital La Fe, Valencia, Spain.

Objective: To compare 2 modalities of bolus-basal insulin therapy with aspart-detemir, according to the moment of administration of detemir (DET), before the lunch or bed-time, in type 1 diabetic patients with poor metabolic control.

Methods: We conducted a prospective study of 40 type 1 diabetic patients, with poor metabolic control (HbAc 7–12%), randomized to receive treatment with 1 injection of DET before the lunch or bed-time and followed-up during 24 weeks. Physician decided the addition of one second dose, administering DET every 12 hours (DET-12 h) if the objectives in glycemic control were not obtained. Insulin analog aspart was used for the post-prandial control. Weight, insulin units/Kg/day, HbA1c, score in a test of quality of life (ITQ7) and hypoglycemias were determined.

Results: 19 patients in DET pre-lunch group and 16 in DET bed-time group completed the study. 10 patients of group DET pre-lunch and 12 of DET bed-time needed DET-12 h. After 24 weeks of bolus-basal insulin therapy, a reduction of HbA1c was demonstrated, and the group DET pre-lunch showed a major reduction of HbA1c. By groups of treatment: DET pre-lunch 8.5 vs 7.1% (P<0,05); DET bed-time 9.0 vs 7.6% (P<0.05.) and DET-12 h 8.8 vs 8.1% (P<0.05.). The ITQ7 demonstrated an improvement without differences between the groups (score baseline visit 74.5±17.3 versus 62.0±19.2; P<0.01). There were no differences in weight and number of non-serious hypoglycemia. Serious hypoglycemia was presented in one patient of DET bed-time group. An increase in the insulin requirements was demonstrated in the 3 groups of treatment (average: 0.78±0.2 u/kg/day in baseline visit versus 0.86±0.2; P<0.05).

Conclusion: after this study, we recommend to begin detemir insulin treatment with one injection administered before the lunch. However, a strict monitoring is necessary because some patients will require two injections of detemir.

Article tools

My recent searches

No recent searches.