Skip to main content
SpringerLink
Log in

Effect of insulin detemir dose frequency on clinical outcomes in patients with diabetes in PREDICTIVE

  • Original Research
  • Published:
Advances in Therapy Aims and scope Submit manuscript

Abstract

Introduction

The aim was to compare clinical outcomes by different dosing frequencies of insulin detemir (detemir) used over 52 weeks in various regimens. Methods: This analysis involved French patients enrolled in PREDICTIVE (a large-scale, multinational, observational study of empirical use of detemir in everyday clinical practice) for whom data have been collected over 52 weeks. Three cohorts were considered: patients with type 1 diabetes; patients with type 2 diabetes using detemir in a basal insulin plus oral antidiabetic drug (OAD) regimen; patients with type 2 diabetes using detemir as part of basal-bolus insulin therapy. In each cohort, data were stratified according to detemir dosing frequency at the beginning and end of 52 weeks: once daily (o.d.) at the beginning and end; twice daily (b.i.d.) at the beginning and end; o.d. at the beginning, but b.i.d. at the end. Endpoints assessed included glycated hemoglobin, fasting plasma glucose, hypoglycemia, weight, and insulin dose.

Results

There were improvements in glycemic control and tolerability in all subgroups. Patients completing on o.d. dosing tended to have better outcomes than those completing on b.i.d. dosing in all cohorts, and o.d. administration was associated with lower insulin dosing. There was little evidence that switching from o.d. to b.i.d. dosing influenced outcomes other than insulin dose. However, there were some baseline differences between subgroups selected for o.d. and b.i.d. dosing that might have influenced outcomes: many patients appeared to have been continued on previous basal dosing frequencies; for others, b.i.d. detemir dosing seemed to be used to intensify previous therapy.

Conclusions

With the caveat that empirical choices of dose frequency were made, this analy-sis shows that empirical use of o.d. detemir produces results at least as good as empirical use of b.i.d. detemir in basal-bolus-treated type 1 and type 2 diabetes, and in basal plus OAD-treated type 2 diabetes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Havelund S, Plum A, Ribel U, et al. The mechanism of protraction of insulin detemir, a long-acting, acylated analog of human insulin. Pharm Res. 2004;21:1498–1504.

    Article  PubMed  CAS  Google Scholar 

  2. Plank J, Bodenlenz M, Sinner F, et al. A double-blind, randomised, dose-response study investigating the pharmacodynamic and pharmacokinetic properties of the long-acting insulin analog detemir. Diabetes Care. 2005;28:1107–1112.

    Article  PubMed  CAS  Google Scholar 

  3. Heise T, Nosek L, Rønn BB, et al. Lower within-subject variability of insulin detemir in comparison to NPH insulin and insulin glargine in people with type 1 diabetes. Diabetes. 2004;53:1614–1620.

    Article  PubMed  CAS  Google Scholar 

  4. Wutte A, Plank J, Bodenlenz M, et al. Proportional dose-response relationship and lower within-patient variability of insulin detemir and NPH insulin in subjects with type 1 diabetes mellitus. Exp Clin Endocrinol Diabetes. 2007;115:461–467.

    Article  PubMed  CAS  Google Scholar 

  5. Klein O, Lynge J, Endahl L, et al. Albumin-bound basal insulin analogs (insulin detemir and NN344): comparable time-action profiles but less variability than insulin glargine in type 2 diabetes. Diabetes Obes Metab. 2007;9:290–299.

    Article  PubMed  CAS  Google Scholar 

  6. Home P, Kurtzhals P. Insulin detemir: from concept to clinical experience. Expert Opin Pharmacother. 2006;7:325–343.

    Article  PubMed  CAS  Google Scholar 

  7. Bartley PC, Bogoev M, Larsen J, et al. Long-term efficacy and safety of insulin detemir compared to neutral protamine Hagedorn insulin in patients with type 1 diabetes using a treat-to-target basalbolus regimen with insulin aspart at meals: a 2-year, randomised, controlled trial. Diabet Med. 2008;25:442–449.

    Article  PubMed  CAS  Google Scholar 

  8. Heise T, Pieber TR. Towards peakless, reproducible and long-acting insulins. An assessment of the basal analogs based on isoglycemic clamp studies. Diabetes Obes Metab. 2007;9:648–659.

    Article  PubMed  CAS  Google Scholar 

  9. Philis-Tsimikas A, Charpentier G, Clauson P, et al. Comparison of once-daily insulin detemir with NPH insulin added to a regimen of oral antidiabetic drugs in poorly controlled type 2 diabetes. Clin Ther. 2006;28:1569–1581.

    Article  PubMed  CAS  Google Scholar 

  10. Le Floch J-P, Lévy M, Mosnier-Pudar H, et al. Comparison of once- versus twice-daily administration of insulin detemir, used with mealtime insulin aspart, in basal-bolus therapy for type 1 diabetes: assessment of detemir administration in a progressive treat-to-target trial (ADAPT). Diabetes Care. 2009;32:32–37.

    Article  PubMed  Google Scholar 

  11. Dornhorst A, Lüddeke HJ, Sreenan S, et al. Safety and efficacy of insulin detemir in clinical practice: 14-week follow-up data from type 1 and type 2 diabetes patients in the PREDICTIVE European cohort. Int J Clin Pract. 2007;61:523–528.

    Article  PubMed  CAS  Google Scholar 

  12. DeVries JH, Nattrass M, Pieber TR. Refining basal insulin therapy: what have we learned in the age of analogs? Diabetes Metab Res Rev. 2007;23:441–454.

    Article  Google Scholar 

  13. Lüddeke HJ, Sreenan S, Aczel S, et al. PREDICTIVE Study Group. PREDICTIVE — a global, prospective observational study to evaluate insulin detemir treatment in types 1 and 2 diabetes: baseline characteristics and predictors of hypoglycaemia from the European cohort. Diabetes Obes Metab. 2007;9:428–434.

    Article  PubMed  Google Scholar 

  14. Meneghini LF, Rosenberg KH, Koenen C, et al. Insulin detemir improves glycaemic control with less hypoglycaemia and no weight gain in patients with type 2 diabetes who were insulin naive or treated with NPH or insulin glargine: clinical practice experience from a German subgroup of the PREDICTIVE study. Diabetes Obes Metab. 2007;9:418–427.

    Article  PubMed  CAS  Google Scholar 

  15. Dornhorst A, Lüddeke HJ, Koenen C, et al. Transferring to insulin detemir from NPH insulin or insulin glargine in type 2 diabetes patients on basalonly therapy with oral antidiabetic drugs improves glycaemic control and reduces weight gain and risk of hypoglycaemia: 14-week follow-up data from PREDICTIVE. Diabetes Obes Metab. 2008;10:75–81.

    PubMed  CAS  Google Scholar 

  16. Dornhorst A, Lüddeke HJ, Sreenan S, et al. Insulin detemir improves glycaemic control without weight gain in insulin-naïve patients with type 2 diabetes: subgroup analysis from the PREDICTIVE study. Int J Clin Pract. 2008;62:659–665.

    Article  PubMed  CAS  Google Scholar 

  17. Honka M. Results of the PREDICTIVE project in the Czech Republic [in Czech]. Vnitr Lek. 2008;54:361–367.

    PubMed  CAS  Google Scholar 

  18. Holman RR, Thorne KI, Farmer AJ, et al. 4-T Study Group. Addition of biphasic, prandial, or basal insulin to oral therapy in type 2 diabetes. N Engl J Med. 2007;357:1716–1730.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Endocrinology-Diabetes, CHRU, Lille, France

    Pierre Fontaine

  2. Unit of Standard Care, C.H.U. Hauts Levêque Hospital, Pessac, France

    Henri Gin

  3. Department of Medicine E, Civil Hospital, Leriche House, Strasbourg, France

    Michel Pinget

  4. Department of Endocrinology-Diabetes, Edouard Herriot Hospital, Lyon, France

    Charles Thivolet

  5. Department of Diabetes, Rangueil Hospital, Toulouse, France

    Hélène Hanaire

  6. Department of Diabetes, Necker Hospital for Ill Children, Paris, France

    Jean-Jacques Robert

  7. Department of Endocrinology-Diabetes, Bichat Hospital, Paris, France

    Michel Marre

  8. Senior International Medical Advisor, International Medical Affairs, Novo Nordisk AS, Virum, Denmark

    Srishyla Venkatanarasimhachar

Authors
  1. Pierre Fontaine
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Henri Gin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Michel Pinget
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Charles Thivolet
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hélène Hanaire
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jean-Jacques Robert
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Michel Marre
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Srishyla Venkatanarasimhachar
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Pierre Fontaine.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fontaine, P., Gin, H., Pinget, M. et al. Effect of insulin detemir dose frequency on clinical outcomes in patients with diabetes in PREDICTIVE. Adv Therapy 26, 535–551 (2009). https://doi.org/10.1007/s12325-009-0033-6

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12325-009-0033-6

Keywords

Search

Navigation