Add-on treatment with intermediate-acting insulin versus sliding-scale insulin for patients with type 2 diabetes or insulin resistance during cyclic glucocorticoid-containing antineoplastic chemotherapy: a randomized crossover study
Open accessAbstract
The aim of this study was to compare the effectiveness and safety of intermediate-acting insulin (IMI) titrated on body weight and glucocorticoid dose with that of short-acting sliding-scale insulin (SSI) in patients on recurrent high-dose glucocorticoid-containing chemotherapy. We enrolled 26 patients with type 2 diabetes mellitus or random blood glucose level >12 mmol/l in a previous cycle of chemotherapy in a randomized crossover study. In two consecutive cycles of glucocorticoid-containing chemotherapy, participants were treated with either IMI or SSI, as add-on to routine diabetes medication. We compared time spent in target range (3.9-10 mmol/l), measured by continuous glucose monitoring (CGM), and the occurrence of hypoglycaemia. IMI resulted in a higher proportion of glucose values within target range than SSI (34.4 vs 20.9%; p < 0.001). There were no severe or symptomatic hypoglycaemic events. Two participants in each group had a subclinical hypoglycaemia detected only by CGM. Once-daily IMI resulted in better glycaemic control than SSI in patients with glucocorticoid-induced hyperglycaemia during chemotherapy. Safety was not compromised as the incidence of hypoglycaemia was low and not different between both regimens.
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- Authors
- Gerards, M. C., de Maar, J. S., Steenbruggen, T. G., Hoekstra, J. B. L., Vriesendorp, T. M., & Gerdes, V. E. A.
- Affiliations
- Slotervaartziekenhuis (NL)
- Department of internal medicine, Isala Zwolle The Netherlands
- The Netherlands Cancer Institute (NL)
- Amsterdam UMC Location University of Amsterdam (NL)
- Isala (NL)
- Corresponding author
- Gerards, M. C.
- Venue
- Diabetes Obesity and Metabolism
- Publisher
- Wiley
- Published
- 2016-07-22
- Volume
- 18
- Issue
- 10
- Pages
- 1041-1044
- ISSN
- 1462-8902 (ISSN-L)
- 1463-1326
- OpenAlex
- W2407563078
- Cited by
- 22
- References
- 15
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 3 · 2023: 1 · 2022: 5 · 2020: 1 · 2019: 1 · 2018: 4 · 2017: 1
- FWCI
- 2.01
- Type
- journal article
- Language
- en
- Open access
- green
- pure.amsterdamumc.nl
- Licence
- Locations
- Diabetes Obesity and Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion, other-oa)
- Funders
- Foundation for Clinical Research Slotervaart Hospital (SKWOSZ)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- intermediate-acting insulin, sliding scale insulin, type 2 diabetes, insulin resistance, cancer chemotherapy, glycemic control, hypoglycemia, continuous glucose monitoring
- MeSH terms
- Aged, Antineoplastic Combined Chemotherapy Protocols, Blood Glucose, Diabetes Mellitus, Type 2, Drug Administration Schedule, Female, Glucocorticoids, Humans, Insulin, Insulin Resistance, Male, Middle Aged, Neoplasms, Cross-Over Studies, Polypharmacy
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