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| |  Type 1 Diabetes Patients Achieve Lower Hypoglycaemia With Insulin Detemir Treatment Than NPH Insulin: Presented at EASD By Bruce Sylvester VIENNA, Austria -- October 7, 2009 -- In a new meta-analysis of 7 trials, type 1 diabetic patients treated with insulin detemir achieved a lower rate of hypoglycaemia than and similar glycaemic control (haemoglobin [Hb] A1C) to patients treated with Neutral Protamine Hagedorn (NPH) insulin, according to findings presented here at the 45th Annual Meeting of the European Association for the Study of Diabetes (EASD). “In a basal-bolus regimen in subjects with type 1 diabetes, the rate of hypoglycaemia was significantly lower with insulin detemir than with a corresponding regimen of NPH,” said Kjeld Hermansen, MD, Aarhus University, Aarhus, Denmark, at a presentation on October 1. As background, the researchers noted that clinical trials usually focus on efficacy, and such trials are usually not powered for analysis of differences in hypoglycaemia between the treatment arms. The researchers performed a meta-analysis to determine the relationship between glycaemic control on treatment and hypoglycaemia in patients with type 1 diabetes. Patients were treated with either insulin detemir or NPH insulin once or twice daily, which was the basal component of a basal-bolus therapy. Data were gathered from 7 randomised clinical trials for which individual patient data were available. The trials lasted >16 weeks and were reported by March 2008. The study included 1,801 subjects on insulin detemir and 1,080 on NPH insulin. Patient characteristics were comparable between the groups: male, 57.9% and 58.5% for the insulin detemir and NPH insulin groups, respectively; mean age, 39.4 and 39.2 years; mean duration of diabetes, 15.6 and 15.1 years; mean body mass index 24.8 and 24.9 mg/m2; and mean Hb A1C at baseline, 8.3% and 8.2%. Patients were treated for 16-104 weeks. The investigators used standard statistical tools to analyse and compare the number of hypoglycaemic episodes during the last 90 days of treatment. They reported that the risk of hypoglycaemia was statistically significantly lower with insulin detemir than with NPH insulin (relative rate = 0.81; P < .001). Independent of Hb A1C, the risk of hypoglycaemia with insulin detemir was 19% lower than with NPH. The investigators also reported that the rate of hypoglycaemia was inversely related to end-of-trial Hb A1C in both regimens, and a 1% decrease in Hb A1C was associated with a 24% increase in the rate of hypoglycaemia. The researchers concluded that compared with NPH insulin, insulin detemir was associated with a lower rate of hypoglycaemia at all levels of glycaemic control. Funding for this study was provided by Novo Nordisk A/S. [Presentation title: Lower Rate of Hypoglycaemia but Comparable Glycaemic Control With Insulin Detemir Compared to NPH Insulin in Patients With Type 1 Diabetes. Abstract 914]
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