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KONJESTİF KALPYETERSiZLİĞİ OLAN TİP 2 DİYABETİKLERDE GÜNDE TEK DOZ GLARGİNE İNSÜLİN TEDAVİSİ İLE GÜNDE 2 KEZ NPH İNSÜLİN TEDAVİSİNİN GECE HİPOGLİSEMİ GÖRÜLME SIKLIĞINA ETKİLERİNİN KARŞILAŞTIRILMASI

COMPARISON OF THE INFLUENCE OF TWICE DAILY NPH INSULIN VERSUS ONCE DAILY GLARGINE INSULIN ON THE FREQUENCY OF NOCTURNAL HYPOGLYCEMIA IN TYPE 2 DIABETIC PATIENTS WITH CONGESTIVE HEART FAILURE

Journal Name:

  • İstanbul Tıp Fakültesi Dergisi

Publication Year:

  • 2007

Key Words:

Keywords (Original Language):

Author Name
Abstract (2. Language): 
Objective: The probability of developing nocturnal hypoglycemia is high in type 2 diabetic patients with existing heart failure. We intended to compare applying single dose of glargine insulin by bedtime against twice daily NPH insulin in terms of creating nocturnal hypoglycemia in such patients. Material and method: The patients demonstrating similar characteristics with respect to age, body mass index, duration of diabetes and heart failure and metabolism were randomized into two groups as insulin glargine (n:19) and NPH (n:11). The subjects have been prospectively followed up for 12 weeks. Results: The maintenance of metabolic control was found to be markedly better in glargine insulin group than those being applied NPH (p< 0.001). The frequency of nocturnal hypoglycemia was observed to be 10.5 % in the insulin glargine group, compared to 9.1 % in the NPH group, which was not a statistically significant difference. The frequency of overall hypoglycemia was higher in patients taking glargine insulin (p= 0.029). Conclusions: While the use of insulin glargine provided a better metabolic control in our study group compared to NPH insulin, it failed to decrease the frequency of nocturnal hypoglycemia. Caution should be taken for nocturnal hypoglycemia when using insulin in type 2 diabetics with concurrent heart failure.
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Abstract (Original Language): 
Amaç: Tip 2 diyabetik hastalara kalp yetersizli¤i de efllik etti¤inde gece hipoglisemisi görülme s›kl›¤› artar. Çal›flmam› zda, bu grup hastalarda günde tek doz glargine insulin tedavisi ile günde 2 kez NPH insulin kullan›lmas›n›n gece hipoglisemi geliflmesi üzerine etkilerini karfl›laflt›rmay› amaçlad›k. Gereç ve yöntem: Yafl, vücut kitle indeksi, diyabet ve kalp yetmezli¤i süreleri ve metabolik göstergeler aç›s›ndan benzer özelliklere sahip hastalar glargine insulin ve NPH insulin tedavi gruplar›na ayr›ld›lar. Hastalar 12 hafta izlendiler. Bulgular: Glisemik kontrolün glargine insulin uygulanan grupta, di¤er gruptan belirgin olarak daha iyi sa¤land›¤› gözlendi (p< 0,001). Gece hipoglisemi görülme s›kl›¤› glargine insulin grubunda % 10,5, NPH grubunda % 9,1 olup istatistiksel olarak farkl› de¤ildi. Genel hipoglisemi oluflma s›kl›¤› ise glargine insulin uygulananlarda fazlayd› (p= 0,029). Sonuç: Günde tek doz Glargine insulin kullan›m› tip 2 diyabetes mellitusla beraber kalp yetersizli¤i olan hastalar› m›zda günde 2 kez NPH insulin kullan›m›na göre daha iyi kan flekeri kontrolü sa¤lam›fl olmakla birlikte gece hipoglisemi görülme s›kl›¤›n› azaltmam›flt›r. Bu nedenle bu grup hastalarda uzun etkili insulin kullan›m›nda gece hipoglisemisi geliflmesi olas›l›¤› bak›m›ndan dikkatli olunmal›d›r.
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PDF icon arastirmax-konjestif-kalpyetersizligi-olan-tip-2-diyabetiklerde-gunde-tek-doz-glargine-insulin-tedavisi-ile-gunde-2-kez-nph-insulin-tedavisinin-gece-hipoglisemi-gorulme-sikligina.pdf
  • 1
11-15
  • Turkish

REFERENCES

References: 

1. Belfiglio M, De Berardis G, Franciosi M, Cavaliere D, Di Nardo
B, Greenfield S, Kaplan SH, Pellegrini F, Sacco M, Tognoni
G, Valentini M, Nicolucci A, Caimi V, Capani F, Corsi A, Della
Vedova R, Massi Benedetti M, Nicolucci A, Taboga C, Tombesi
M, Vespasiani G. The Relationship Between Physicians’Self-
Reported Target Fasting Blood Glucose Levels and Metabolic
Control in Type 2 Diabetes: The QuED Study Group-Quality of
care and outcomes in type 2 diabetes. Diabetes Care 2001; 24:
423-429.
2. Chase HP, Lockspeiser T, Peery B, Shepherd M, MacKenzie T,
Anderson J, Garg SK. The impact of diabetes control and complications
trial and humalog insulin on glycohemoglobin levels
and severe hypoglycemia in type 1 diabetes. Diabetes Care
2001; 24:430-434.
3. Chatterjee S, Tringham JR, Davies MJ. Insülin glargine and its
place in the treatment of Types 1 and 2 Diabetes Mellitus. Expert
Opin Pharmacother 2006; 7:1357-1371.
4. Desouza C, Salazar H, Cheong B, Murgo J, Fonseca V. Association
of hypoglycemia and cardiac ischemia, Diabetes Care
2003; 26:1485-1489.
5. Intensive blood-glucose control with sulphonylureas or insulin
compared with conventional treatment and risk of complications
in patients with type 2 diabetes (UKPDS 33). UK Prospective
Diabetes Study (UKPDS) Group. Lancet 1998; 352:837-853.
6. Landstedt-Hallin L, Adamson U, Lins P-E: Oral glibenclamide
suppresses glucagon secretion during insülin-induced hypoglycemia
in patients with type 2 diabetes. J Clin Endocrinol Metab
1999; 84 :3140-3145.
7. McKeage K, Goa KL. Spotlight on insülin glarjin in type 1 and
2 Diabetes Mellitus. Treat Endocrinol 2002; 1:55-58.
8. Raskin P, Klaff L, Bergenstal R, Halle JP, Donley D, Mecca T.
A16-week comparison of the novel insülin analog insülin glarjin
(HOE 901) and NPH human insülin used with insülin lispro
in patients with type 1 diabetes. Diabetes Care 2000; 23:1666-
1671.
9. Rosenstock J, Schwartz SL, Clark CM Jr, Park GD, Donley DW,
Edwards MB. Basal Insülin Therapy in Type 2 Diabetes: 28-week
comparison of insülin glarjin (HOE 901) and NPH insülin,
Diabetes Care 2001; 24:631-636.
10. Stratton IM, Adler AI, W Neil HA, Matthews DR, Manley SE,
Cull CA, Hadden D, Turner RC, Holman RR. Association of
glycaemia with macrovascular and microvascular complications
of type 2 diabetes (UKPDS 35): prospective observational
study, BMJ 2000; 321:405- 412.
11. United Kingdom Prospective Diabetes Study (UKPDS). 13:Relative
efficacy of randomly allocated diet, sulphonylurea, insülin,
or metformin in patients with newly diagnosed non-insülin
dependent diabetes followed for three years, BMJ 1995; 310:83-
88.
12. Yki-Jarvinen H, Dressler A, Ziemen M; HOE 901/3002 Study
Group. Less nocturnal hypoglycemia and better post-dinner glucose
control with bedtime insulin glarjin compared with bedtime
NPH insülin during insülin combination therapy in type 2 diabetes.
HOE 901/3002 Study Group. Diabetes Care 2000;
23:1130-1136.
13. Zammitt NN, MRCP and Brian M. Frier. Hypoglycemia in Type
2 Diabetes Pathophysiology, frequency, and effects of different
treatment modalities. Diabetes Care 2005; 28: 2948-2961.

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