Comparative Study of NPH Insulin with Glargine in Patients of Type 2 Diabetes Mellitus Poorly Controlled With Oral Hypoglycaemic Agents.
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Date
2016-11
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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.
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Keywords
Glargine, Glycemic control, Nocturnal hypoglycaemia, NPH insulin, Type 2 Diabetes mellitus
Citation
Bal Baljinder Singh, Salwan Surinder Kumar, Duggal Ashok, Farooq Mohammed Umar. Comparative Study of NPH Insulin with Glargine in Patients of Type 2 Diabetes Mellitus Poorly Controlled With Oral Hypoglycaemic Agents. Annals of International Medical and Dental Research. 2016 Nov-Dec; 2(6): 33-37.