Small weight loss achieved after
switching to long-acting insulin
People with diabetes who switch to the longacting
insulin analogue detemir (Levemir)
may benefit from fewer insulin-associated
side effects such as weight gain, preliminary
data from a clinical practice study suggest.
The results come from a prospective study
of more than 30,000 patients with type 1 or
type 2 diabetes from 19 countries.The open-label
study examined outcomes for patients
who either added detemir to their oral antidiabetic
regimen or switched to it from other
long- or intermediate-acting insulins (insulin
glargine or isophane).
This analysis, from the German arm of the
study, included 260 patients who were taking
insulin glargine and 251 receiving isophane
before enrolment into the study. Most patients
continued oral antidiabetic medicines
and used once-daily dosing of detemir. Both
groups (those who had been using insulin
glargine and those who had been using isophane)
initially had inadequately controlled
diabetes with HbA1c levels higher than recommended
at an average of 7.8 per cent
each. After three months, the HbA1c had decreased
to 7.23 per cent in both groups of patients
(P=0.001).
The rates of overall, major and night-time
hypoglycaemia also fell for both groups and
no major hypoglycaemic events occurred
during detemir treatment.
Insulin treatment is typically associated
with weight gain, but patients switched to detemir
had a small but significant weight loss
of 0.9kg from baseline on isophane and 0.7kg
from baseline on insulin glargine over the
three-month study period (P=0.001).
Malcolm Nattrass, consultant diabetologist
at University Hospital Birmingham NHS
Trust, said: “Fear of weight gain is a major
barrier to patients starting insulin treatment
and the worry is they will get into a vicious
circle of getting more obese, leading to increased
insulin resistance and further weight
gain.”
The data were presented at the American
Diabetes Association annual
scientific sessions,
held in Washington last month. |
The
Pharmaceutical Journal
Acrobat
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