The utility of insulin glargine in the treatment of diabetes mellitus

Study Objectives. To compare hemoglobin A(1c) (A1C) values at baseline with those after 1 year of insulin glargine therapy and, secondarily, to compare insulin dosage and patients' body weight at baseline and at 1 year. Design. Retrospective study. Setting. Private endocrinology practice. Patients. One hundred ninety-seven patients with diabetes mellitus who were first prescribed insulin glargine from May 2001-April 2002 and were evaluable after 1 year of therapy. Intervention. Patients received insulin glargine instead of NPH insulin or in addition to their oral drug therapy Measurements and Main Results. Patients with diabetes type 1 (receiving insulin therapy) or type 2 (receiving oral drug therapy only, a combination of oral drug therapy and insulin, or insulin only) who had been treated with insulin glargine for I year were evaluated. Overall, A1C values decreased significantly (p < 0.001) by 0.53 +/- 1.4% from a baseline mean of 8.1 +/- 1.7%. In 129 patients with type 2 diabetes previously treated with NPH insulin, A1C decreased significantly (p < 0.001) 0.57 +/- 1.5% from baseline. The A1C decreased by 0.71 +/- 1.3% (p = 0.0043) from baseline in 33 patients with type 2 diabetes who previously received oral agents only Thirty-five patients with type I diabetes demonstrated no significant change in A1C (-0.22 +/- 1.0%, p = 0.217) from baseline. In patients receiving insulin at baseline, the number of daily injections increased significantly (p < 0.0001) from a median of two at baseline to three at 1 year. Overall, no significant change was noted in total daily insulin requirement or in body weight in any of the patient groups over the 1-year period. Conclusion. Compared with baseline, insulin glargine therapy at 1 year was associated with an overall significant reduction in A1C of 0.53 +/- 1.4%.