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Diabetes Obes Metab ; 18(10): 1041-4, 2016 10.
Article in English | MEDLINE | ID: mdl-27191794

ABSTRACT

The aim of this study was to compare the effectiveness and safety of intermediate-acting insulin (IMI) titrated on body weight and glucocorticoid dose with that of short-acting sliding-scale insulin (SSI) in patients on recurrent high-dose glucocorticoid-containing chemotherapy. We enrolled 26 patients with type 2 diabetes mellitus or random blood glucose level >12 mmol/l in a previous cycle of chemotherapy in a randomized crossover study. In two consecutive cycles of glucocorticoid-containing chemotherapy, participants were treated with either IMI or SSI, as add-on to routine diabetes medication. We compared time spent in target range (3.9-10 mmol/l), measured by continuous glucose monitoring (CGM), and the occurrence of hypoglycaemia. IMI resulted in a higher proportion of glucose values within target range than SSI (34.4 vs 20.9%; p < 0.001). There were no severe or symptomatic hypoglycaemic events. Two participants in each group had a subclinical hypoglycaemia detected only by CGM. Once-daily IMI resulted in better glycaemic control than SSI in patients with glucocorticoid-induced hyperglycaemia during chemotherapy. Safety was not compromised as the incidence of hypoglycaemia was low and not different between both regimens.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/drug therapy , Glucocorticoids/administration & dosage , Insulin Resistance , Insulin/administration & dosage , Neoplasms/complications , Neoplasms/drug therapy , Aged , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Blood Glucose/drug effects , Blood Glucose/metabolism , Cross-Over Studies , Diabetes Mellitus, Type 2/blood , Drug Administration Schedule , Female , Glucocorticoids/adverse effects , Humans , Insulin/adverse effects , Insulin/analogs & derivatives , Insulin Resistance/physiology , Male , Middle Aged , Neoplasms/blood , Polypharmacy
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