Comparative Study of NPH Insulin with Glargine in Patients of Type 2 Diabetes Mellitus Poorly Controlled With Oral Hypoglycaemic Agents.

ABSTRACT

Background: Type 2 Diabetes Mellitus is an emerging pandemic with number of patients increasing rapidly in both developed and developing nations. In patients with secondary failure of type 2 diabetes after oral hypoglycaemic agents (OHAs), Insulin is the treatment, which is available in various forms with respect to viable duration of action. Basal Insulins or background insulins are used commonly either alone or with short acting insulins. NPH insulin is intermediate acting insulin given once or twice daily whereas Glargine is long acting insulin given once daily. Methods: In this study, 120 patients of type 2 diabetes mellitus already on oral hypoglycaemic agents who were not optimally controlled with combination of 2 or 3 oral hypoglycaemic agents were included after excluding patients of Type 1 diabetes, gestational diabetes and those who were newly diagnosed or already on insulin therapy. Patients were divided into 2 groups of 60 patients each. Group A were put on NPH insulin and Group B on Glargine insulin for 12 weeks. Along with parameters of diabetes and side effects were compared with special reference to early morning hypoglycaemia (at 3 am).Results: Mean reduction in fasting blood glucose was 54.42 mg/dl in Group A as compared to 66.62 mg/dl in Group B, which was statistically significant with a p value < 0.0001. Regarding hypoglycaemia it was seen in 31.67% in Group A vs. 11.67% in Group B and was significant (p=0.0078). Nocturnal hypoglycaemia was also seen to be more in Group A than Group B with values of 21.67% and 5% respectively, which was significant. There was no significant difference in daily dose requirement. Conclusion: This study showed that Insulin Glargine was better than Insulin NPH in terms of glycemic control and less side effects with respect to hypoglycemic events and nocturnal hypoglycemia with no significant difference in daily dose requirements.