Aim: We had the aim to determine the insulin treatment strategy that could prevent or decrease the occurrence of hypoglycaemia while providing better regulation of blood glucose in Tip 2 diabetic patients with cardiac failure.
Method: The patients demonstrating similar characteristics with respect to the age, body mass index, the duration of diabetes and heart failure were randomized into two groups as insulin glargine (n: 19) and NPH (n: 11). The subjects have been prospectively followed up for 12 weeks.
Results: Basal blood glucose level was detected as 197.21±69.01 in insulin glargine group(group1), it was 175.45±52.26 in NPH insulin group(group2) (P=0.339). Basal postprandial blood glucose in group1 was found to be 191.42±63.42, it was 186.18±81.82 In group2 (P=0.857). The nocturnal(3.00 am) blood glucose was 191.42±63.42 in group1, it was 186.18±81.82 in group2 (P=0.857). In group1, basal HbA1c value was 8.11±1.98, which was found to be 7.88±1.49 in group2 (P=0.728). At week 12 of insulin therapy, HbA1c value was 6.86±1.59% in group1, markedly decreased compared to initial HbA1c value (P<0.001). In NPH group, HbA1c was found to be 7.31±1.36% at week 12, which was also lower than that at the beginning of the treatment, however this result was not statistically significant (P=0.417). The frequency of nocturnal hypoglycaemia in group1 was detected to be 10.5%, compared to 9.1% in group2. In two groups did not show any statistical difference related to the frequency of nocturnal hypoglycaemia.
Conclusion: In our study, while the use of insulin glargine provided a better metabolic control compared to NPH insulin,but it failed to decrease the frequency of nocturnal hypoglycaemia in diabetic subgroup with cardiac failure.