Document Detail


Insulin Glargine or NPH in Patients with Severe Insulin Resistance: Is there a Benefit?
MedLine Citation:
PMID:  22232027     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective: To report the benefit of NPH insulin compared to insulin glargine in a patient with type 2 diabetes associated with severe insulin resistance.Methods: We describe a 52-year-old male with 3-year history of type 2 diabetes who failed to achieve adequate glucose control, despite escalating his regimen of insulin glargine to 80 units twice a day with insulin lispro 60 units before each meal, in addition to metformin.Results: Dietary and lifestyle changes were emphasized and implemented while medication adherence with appropriate insulin technique was reviewed at each visit. The decision was made to replace insulin glargine with the same dose of NPH insulin. After 3 months, a significant drop in HbA1c was noted, from 9.5 to 6.1%, consistent with the improved capillary glucose measurements. The effect was maintained over the following year, without any major hypoglycemic events.Conclusion: NPH insulin might be superior to the long acting analogue glargine in cases of severe insulin resistance, but randomized studies are needed to confirm our finding and clarify the involved mechanisms.
Authors:
Vasile M Bota; Irl B Hirsch
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-1-9
Journal Detail:
Title:  Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists     Volume:  -     ISSN:  1934-2403     ISO Abbreviation:  -     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-1-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9607439     Medline TA:  Endocr Pract     Country:  -    
Other Details:
Languages:  ENG     Pagination:  1-9     Citation Subset:  -    
Affiliation:
Roger Williams Medical Center, Boston University School of Medicine, Providence, RI.
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