Clinical experience of switching from glargine or neutral protamine Hagedorn insulin to insulin detemir in type 2 diabetes: Observations from the Indian cohort in the A 1 chieve study
Subhash Kumar Wangnoo1, Samit Ghosal2, Shahid Akhtar3, Raman Shetty3, Sudhir Tripathi4
1 Indraprashtha Apollo Hospital, New Delhi, India
2 Nightingale Hospital, Kolkata, West Bengal, India
3 Novo Nordisk India Private Limited, Bangalore, Karnataka, India
4 Sir Ganga Ram Hospital, New Delhi, India
Novo Nordisk India Private Ltd., Plot No. 32, 47 50, EPIP Area, Whitefield, Bangalore - 560 066, Karnataka
Source of Support: This study was sponsored by Novo Nordisk A/S, Denmark.
The sponsor took part in the development of the protocol, the process of data
collection and analysis, funding of medical writing services, and in reviewing
the manuscript, but not in participant selection, choice of therapies (study
or otherwise), provision of therapies including insulin or continuing clinical
management of the participants., Conflict of Interest: None
Clinical trial registration NCT00869908
Aim: To explore the clinical safety and effectiveness of insulin detemir (IDet) in a subgroup of Indian patients with type 2 diabetes (T2D) switched from either insulin glargine (IGlar) or neutral protamine Hagedorn (NPH) insulin in the 24-week, non-interventional A 1 chieve study. Materials and Methods : Indian patients with T2D switching from pre-study IGlaror NPH insulin to IDet were included. Safety and effectiveness outcomes were evaluated by the physicians in local clinical settings. Results : A total of 102 patients switched from IGlar to IDet (GLA group) and 39 patients switched from NPH insulin to IDet (NEU group). At baseline, the mean glycated hemoglobin A 1c (HbA 1c ) levels were 9.9 ± 1.8% in the GLA group and 9.1 ± 1.2% in the NEU group. No serious adverse drug reactions, serious adverse events, or major hypoglycemic events were reported in either group throughout the study. At baseline and Week 24, 11.8% and 7.5% of patients, respectively, reported overall hypoglycemic events in the GLA group. No hypoglycemic events were reported at Week 24 in the NEU group. At Week 24, the mean HbA 1c levels were 7.6 ± 0.9% in the GLA group and 7.3 ± 0.7% in the NEU group. The mean fasting plasma glucose, postprandial plasma glucose and quality of life also appeared to improve over 24 weeks. Conclusion: Switching to IDet therapy from IGlar and NPH insulin was well-tolerated and appeared to be associated with improved glycogenic control in Indian patients.