ABSTRACT
AIMS: To compare blood glucose control using insulin glargine + insulin lispro with that on NPH insulin + unmodified human insulin in adults with Type 1 diabetes managed with a multiple injection regimen. METHODS: In this 32-week, five-centre, two-way cross-over study, people with Type 1 diabetes (n = 56, baseline HbA1c 8.0 +/- 0.8%) were randomized to evening insulin glargine + mealtime insulin lispro or to NPH insulin (once- or twice-daily) + mealtime unmodified human insulin. Each 16-week period concluded with a 24-h inpatient plasma glucose profile. RESULTS: HbA1c was lower with glargine + lispro than with NPH + human insulin [7.5 vs. 8.0%, difference -0.5 (95% CI -0.7, -0.3) %, P < 0.001]. This was confirmed by an 8% lower 24-h plasma glucose area under the curve (AUC) (187 vs. 203 mmol l(-1) h(-1), P = 0.037), a 24% reduction in plasma glucose AUC > 7.0 mmol/l1 (47 vs. 62 mmol l(-1) h(-1), P = 0.017) and a 15% lower post-prandial plasma glucose AUC (75 vs. 88 mmol l(-1) h(-1), P = 0.002). There was no reduction in night-time plasma glucose AUC or increase in plasma glucose area < 3.5 mmol/l. Monthly rate of nocturnal hypoglycaemia was reduced by 44% with glargine + lispro (0.66 vs. 1.18 episodes/month, P < 0.001). CONCLUSIONS: Compared with NPH insulin + unmodified human insulin, the combination of insulin glargine with a rapid-acting insulin analogue as multiple-injection therapy for Type 1 diabetes improves overall glycaemic control as assessed by HbA1c and 24-h plasma glucose monitoring to a clinically significant degree, together with a reduction in nocturnal hypoglycaemia.
Subject(s)
Blood Glucose/analysis , Diabetes Mellitus, Type 1/drug therapy , Hypoglycemic Agents/therapeutic use , Insulin/therapeutic use , Adult , Area Under Curve , Blood Glucose Self-Monitoring , Cross-Over Studies , Drug Therapy, Combination , Female , Glycated Hemoglobin/analysis , Humans , Hypoglycemia/blood , Hypoglycemic Agents/adverse effects , Insulin/adverse effects , Insulin/analogs & derivatives , Insulin Glargine , Insulin Lispro , Insulin, Isophane/adverse effects , Insulin, Isophane/therapeutic use , Insulin, Long-Acting , Male , Treatment OutcomeABSTRACT
MEASURING TEMPERATURE IN WOUND HEALING WATER VAPOUR TRANSMISSION RATES DYNAMIC PULSATION THERAPY.
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STIMULATION OF ANGIOGENESIS BY GROWTH FACTORS CHRONIC VENOUS DISEASE OF THE LEG.
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MEASURING WOUND VOLUME: ACCURACY OF ALGINATE MOULDS HYALURONIC ACID IN HEALING CHRONIC WOUNDS.
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TOXICITY OF ANTISEPTIC WOUND CLEANSERS PSEUDOMONAS FOLLICULITIS ENZYME DEBRIDEMENT.
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FINDING THE TRUE PREVALENCE OF LEG ULCERS WOUND CARE AND MRSA.
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NOISE AND WOUND HEALING FOUR-LAYER BANDAGE STUDY MANAGEMENT SYSTEMS NECROTISING FASCIITIS DISFIGURING INJURIES.
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This paper reports a rare form of ulceration of the lower leg and, as a result of subsequent investigations and literature review, readdresses a recent debate regarding the legitimate classification of these ulcers as a separate disease entity.
Subject(s)
Leg Ulcer/classification , Female , Humans , Leg Ulcer/diagnosis , Leg Ulcer/pathology , Middle AgedABSTRACT
Standardised assessment and evaluation of wounds Nutritional support in wound healing Pressure sores, a review of the literature Gene therapy in skin grafts Surgical techniques in pilonidal disease Prognostic usefulness of serum albumin for pressure ulcer healing.
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Topical cytokines and wound healing A digest and review of wound care issues in other journals Operating theatre practices and wound care Civilian gunshot wounds Wound treatments: old or new? Lasers in surgery.
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Bacterial infection in chronic wounds The care of patients with atopic eczema Venous incompetence and the results of foot volumetry Mortality and surgical wound infection The use of interleukin-1ß in the treatment of pressure sores.
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Wound healing in the fetus Community management of patients with chronic leg ulcers Increase in malignant melanoma Pressure sore risk calculators Decreased immune responsiveness in older people.
