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Once-Daily Insulin Shot Proves Effective in Study


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"Diabetes is a worsening epidemic worldwide and studies examining glycemic control are very important," said Dr. Spyros Mezitis, an endocrinologist at Lenox Hill Hospital in New York City. "Diabetes is not well controlled in many patients and insulin is not used early enough in the treatment algorithm for type 2 diabetes to achieve maximal benefit."

Lantus is known as a "basal" insulin analogue, meaning it is given once a day either in the morning or at night; it lasts for about 24 hours. Insulin lispro is shorter-acting and is administered with meals.

For the new study, more than 400 men and women with type 2 diabetes that was poorly controlled by oral medication were randomly assigned to receive either Lantus or Humalog. The trial, conducted at 69 study sites in Europe and Australia, lasted 44 weeks. All participants continued to take oral medications.

Text Continues Below



Blood sugar control was about equivalent in the two groups, with a decrease of 1.7 percent in the Lantus group and 1.9 percent in the Humalog group.

Lantus was associated with a lower risk of low blood sugar. It also offered the advantages of fewer injections and less blood glucose monitoring throughout the day (only once before breakfast). People taking Lantus also experienced less weight gain, the study authors said.

Certainly, Lantus seems to present another, viable option for people with type 2 diabetes, and one that fits with current treatment recommendations, Kirkman said.

"The American Diabetes Association has a consensus treatment algorithm for type 2 diabetes and insulin is suggested as a second- or third-line treatment," she said. "The suggestion is to start with basal insulin, but that's really primarily because it tends to be easier to convince a patient to go on one shot a day."

Dr. Juan Castro, director of the Texas A&M Health Science Center Coastal Bend Health Education Center, said, "I don't think it [the new study] is going to revolutionize what we're doing but, to clinicians, it really supports what we have seen in the Hispanic population. Historically there has been a lot of resistance with Hispanic patients to accept the idea of being on insulin. This basal insulin gives us a good transition to help patients accept insulin because it's only once a day. If, two to three months later, we need to give them lispro, it's easier for them to accept it."

More information

The American Diabetes Association has more on insulin.

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Copyright © 2008 ScoutNews, LLC. All rights reserved.
Last updated 3/28/2008

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SOURCES: Sue Kirkman, M.D., vice president, clinical affairs, American Diabetes Association, Alexandria, Va.; Spyros Mezitis, M.D., endocrinologist, Lenox Hill Hospital, New York City; Juan Castro, M.D., director, Texas A&M Health Science Center Coastal Bend Health Education Center, Corpus Christi; March 29, 2008, The Lancet


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