Endocrine Abstracts

Introduction: Over the past two decades, the development of genetic engineering techniques has led to the emergence of insulin analogue that have the advantage of improving diabetics quality of life compared to human insulin. The aim of our study was to compare the frequency of occurrence of degenerative complications in two groups of patients with type 2 diabetes (T2D) on human insulin (NPH) and analogue insulin, and thus determine whether or not there are benefits to prescribing analogue insulin.

Materials and methods: Prospective comparative study involving 88 T2D patients, carried within the National Institute of Nutrition in Tunis and hospitalized for insulin therapy. Patients were divided into two groups: (G1) including 44 patients on human insulin and (G2) including 44 patients on analogue insulin. The presence or absence of degenerative complications was noted in both groups 18 months after insulin.

Results: Median age was 55,6 years in G1 versus 52,8 years in G2 (P = NS). Median diabetes duration was 7,1 years in G1 compared to 8,92 years in G2 (P = NS). Peripheral neuropathy was the most common complication in both groups (59,1% in G1 versus 68,2% in G2; P = NS). Diabetic retinopathy was present in 36,6% in G1 versus 40,4% in G2 (P = NS). Diabetic nephropathy was more present in G1 than in G2 (28,9% versus 20%; P = NS). Impaired renal function was more present in G1 than in G2 (41% versus 39%; P = NS). Coronary heart failure was the most common macrovascular complication in both groups (29,6% in G1 and 25,3% in G2). There was no statistically significant difference (P = NS) between the two groups for each of the macrovascular complications.

Conclusion: The two groups were comparable for the frequency of occurrence of different micro and macro vascular complications. In addition, patients on insulin analogue were less likely to develop diabetic nephropathy, renal failure and coronary heart failure.