Insulin Glulisine Provides Improved Glycemic Control in Patients With Type 2 Diabetes
Abstract
OBJECTIVE—Insulin glulisine is a novel analog of human insulin designed for use as a rapid-acting insulin. This study compared the safety and efficacy of glulisine with regular human insulin (RHI) in combination with NPH insulin. RESEARCH DESIGN AND METHODS—In total, 876 relatively well-controlled patients with type 2 diabetes (mean HbA1c 7.55%) were randomized and treated with glulisine/NPH (n = 435) or RHI/NPH (n = 441) for up to 26 weeks in this randomized, multicenter, multinational, open-label, parallel-group study. Subjects were allowed to continue the same dose of prestudy regimens of oral antidiabetic agent (OAD) therapy (unless hypoglycemia necessitated a dose change). RESULTS—A slightly greater reduction from baseline to end point of HbA1c was seen in the glulisine group versus RHI (−0.46 vs. −0.30% with RHI; P = 0.0029). Also, at end point, lower postbreakfast (156 vs. 162 mg/dl [8.66 vs. 9.02 mmol/l]; P < 0.05) and postdinner (154 vs. 163 mg/dl [8.54 vs. 9.05 mmol/l]; P < 0.05) blood glucose levels were noted. Symptomatic hypoglycemia (overall, nocturnal, and severe) and weight gain were comparable between the two treatment groups. There were no between-group differences in baseline-to-end point changes in insulin dose. CONCLUSIONS—Twice-daily glulisine associated with NPH can provide small improvements in glycemic control compared with RHI in patients with type 2 diabetes who are already relatively well controlled on insulin alone or insulin plus OADs. The clinical relevance of such a difference remains to be established.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The very rapid-acting and long-acting insulin analogues have not been shown to lower A1C levels more effectively than the older, rapid-acting or intermediate-acting formulations.
“The very rapid-acting and long-acting insulin analogues have not been shown to lower A1C levels more effectively than the older, rapid-acting or intermediate-acting formulations (71–73).”
From Medical Management of Hyperglycemia in Type 2 Diabetes: A Consensus Algorithm for the Initiation and Adjustment of Therapy (2009) · cites this paper as [73]
Rapid-acting insulin analogs, such as lispro and glulisine, were also associated with a lower frequency of hypoglycemia in people with type 2 diabetes when compared with short-acting (soluble) regular insulins.
“Rapid-acting insulin analogs, such as lispro and glulisine, were also associated with a lower frequency of hypoglycemia in people with type 2 diabetes when compared with short-acting (soluble) regular insulins (138 -140).”
From Hypoglycemia in Type 2 Diabetes (2005) · cites this paper as [140]
The citation lists haven’t been fetched yet
References 14 · Cited by 153
- Authors
- Dailey, G., Rosenstock, J., Moses, R. G., & Ways, K.
- Affiliations
- Scripps Clinic (US)
- Dallas Diabetes and Endocrine Center, Dallas, Texas
- Wollongong Hospital (AU)
- Aventis Pharma, Bridgewater, New Jersey
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2004-10-01
- Volume
- 27
- Issue
- 10
- Pages
- 2363-2368
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2171116761
- Cited by
- 153
- References
- 14
- Citations by year
- 2024: 4 · 2023: 2 · 2022: 4 · 2021: 2 · 2020: 3 · 2019: 5 · 2018: 1 · 2017: 4 · 2016: 3 · 2015: 7 · 2014: 4 · 2013: 11 · 2012: 6
- FWCI
- 8.89
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- insulin glulisine, type 2 diabetes, glycemic control, rapid-acting insulin analogs, regular insulin, NPH insulin, HbA1c, postprandial blood glucose, hypoglycemia, weight gain, insulin dose adjustment, oral antidiabetic drugs
- MeSH terms
- Aged, Blood Glucose, Diabetes Mellitus, Type 2, Dose-Response Relationship, Drug, Drug Administration Schedule, Female, Follow-Up Studies, Glycated Hemoglobin, Humans, Hypoglycemia, Injections, Subcutaneous, Insulin, Insulin, Isophane, International Cooperation, Male, Middle Aged, Probability, Reference Values, Severity of Illness Index, Single-Blind Method, Treatment Outcome, Risk Assessment
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
