Good Glycemic Control With Flexibility in Timing of Basal Insulin Supply
A 24-week comparison of insulin glargine given once daily in the morning or at bedtime in combination with morning glimepiride
- Eberhard Standl, MD1,
- Stephan Maxeiner, MD2,
- Sotirios Raptis, MD (HON)3,
- Zahra Karimi-Anderesi, MD4,
- Matthias Axel Schweitzer, MD4 and
- the HOE901/4009 Study Group
- 13 Medical Department, Munich Diabetes Research Institute, Krankenhaus München-Schwabing, Munich, Germany
- 2Internist/Diabetologe, Bad Kreuznach-Bosenheim, Germany
- 32nd Department of Internal Medicine, Research Institute and Diabetes Center, Athens University, Atthikon University General Hospital, Athens, Greece
- 4Aventis Pharma Deutschland, Bad Soden am Taunus, Germany
- Address correspondence and reprint requests to Professor Eberhard Standl, MD, Munich Diabetes Research Institute, 3 Medical Department, Krankenhaus München-Schwabing, Kölner Platz 1, D-80804, Münich, Germany. Email: eberhard.standl{at}lrz.uni-muenchen.de
The early initiation of insulin therapy to achieve good metabolic control is being increasingly considered in type 2 diabetes (1), but barriers, including fear of hypoglycemia, need to be overcome to achieve target glycemic control (2).
Insulin glargine (glargine; Lantus) is a once-daily, basal human insulin analog. The 24-h duration and flat time-action profile of glargine (3) should give flexibility to patients in terms of the injection time despite targeting fasting blood glucose (FBG) close to normal: administration should be possible at any time of day provided it is at the same time each day. Previously, we have demonstrated similar levels of nocturnal hypoglycemia but better glycemic control with morning versus bedtime glargine plus three milligrams glimepiride (4).
RESEARCH DESIGN AND METHODS
The study objective was to compare the frequency of nocturnal hypoglycemia following morning …
