Efficacy and safety of insulin detemir in type 2 diabetes patients by the combined application of continuous glucose monitoring system and hyperinsulinemic-euglycemic clamp technique

Abstract

Objective To evaluate efficacy, safety and effect of glycemic excursion of once-daily insulin detemir added to oral antidiabetic drugs in poorly controlled type 2 diabetes patients by continuous glucose monitoring system(CGMS) and Hyperinsulinemic-euglycemic Clamp Technique. Methods 20 type 2 diabetes patients with poor glycemic control by oral antidiabetic drugs were added to receive once-daily bedtime insulin detemir injection. The observation lasted for three months. The parameters were measured before and after treatment included M value, AIR, MAGE, MODD by continuous glucose monitoring system(CGMS) and Hyperinsulinemic-euglycemic Clamp Technique. The parameters included BMI, TC, TG, LDL, HDL, C-P and HbA1c also were measured before and after treatment. Data analysis were performed using SPSS 16.0. Results After 3 months' treatment, HbA1c, WHR, TC, LDL were significantly decreased than before, respectively((8.8±1.6)%, (7.6±1.3)%, t=4.830, P<0.001; (0.95±0.04)mmol/L, (0.94±0.04)mmol/L, t=2.317, P<0.05; (5.1±0.6) mmol/L, (4.5±0.9) mmol/L, t=3.459, P<0.01; (3.2±0.8) mmol/L, (2.6±0.8) mmol/L, t=3.822, P<0.01) M value was significantly increased than before ((3.9±2.1) mg·min-1·kg-1, (5.0±2.4)mg·min-1·kg-1,t=-2.269, P<0.05), AIR was also increased but no statistical difference. Detemir treatment also obviously reduced MAGE from (7.3 ± 2.4)mmol/L to(5.4±2.9)mmol/L, there were significances in statistics. But there was no statistical difference in MODD after treatment. After detemir treatment, the value of weight was decreased than before, but with no statistical difference.There was no serious hypoglycemia. Conclusion Once-daily insulin detemir added to oral antidiabetic drugs in poorly controlled type 2 diabetes patients could improved glycemic control, the insulin sensitivity and reduced glycemic. Key words: Diabetes mellitus, type 2; Insulin detemir; Continuous glucose monitoring system; Hyperinsulinemic-euglycemic clamp technique; Glycemic excursion