Efficacy and safety of adding single dose insulin glargine in patients with type 2 diabetes uncontrolled by oral hypoglycemic drugs

Abstract

BACKGROUND:The addition of the long acting insulin glargine (Lantus) to the regimen of multiple oral hypoglycemic drugs in patients with uncontrolled type 2 diabetes mellitus has long been studied in terms of efficacy (e.g. HbA1c reduction) and safety ( e.g.incidence of hypoglycemia).OBJECTIVES: The aim of this study was to assess 1) effectiveness in controlling hyperglycemia 2) safety in terms of the incidence of hypoglycemia, after the addition of a single dose of insulin glargine to the previous regimen of oral hypoglycemic drugs in patients with uncontrolled type 2 diabetes. PATIENTS AND METHODS:200 patients with long standing (5-10 years) type 2 diabetes mellitus uncontrolled by multiple oral hypoglycemic drugs (HbA1c 9.5-13%) attending the diabetes center in Diwaniya, were selected to add a single titrated dose of insulin Glargine to their oral regimen and followed for 6 months to evaluate their glycemic control (as defined by HbA1c and FPG) and safety regarding the incidence of moderate and severe hypoglycemia.RESULTS:After 6 months, ,109 patients Of total 200 patients (54.5%) achieved both targets, HbA1c reduction (> 7 %) and fasting plasma glucose (> 130mg/dl), among them only 3 patients (2.7%) developed severe hypoglycemia and 17 patients (15.5%) developed mild to moderate hypoglycemia.64 patients (32%) achieved HbA1c between ( 7 - 7.5% ) ,among them only 8 patients(12.5%) developed mild hypoglycemia. of the total 200 patients ,20 patients (10%) had their HbA1c between (7.5 – 8%) with only 2 patients among them (10%) had mild hypoglycemia. only 7 patients of the total 200 (3.5%( had HbA1c > 8% without hypoglycemia.