Efficacy of Glargine Insulin Compared with Neutral Protamine Hagedorn Insulin in Patients with Type 2 Diabetes not Controlled with Oral Hypoglycemics: A Cohort Study

Abstract

Objective: To compare the efficacy of Glargine Insulin with Neutral Protamine Hagedorn (NPH) Insulin in patients with uncontrolled type 2 diabetes with oral hypoglycemic.
 Study Design: Prospective cohort study.
 Place and Duration of the Study: Railway Hospital, Rawalpindi Pakistan, from Nov 2020 to Jul 2021.
 Methodology: All patients aged 30-70 years of either gender, presented with uncontrolled diabetes mellitus on oral hypoglycemic for ≥1 year were enrolled. Patients were divided into Insulin Glargine and injection NPH subcutaneously by lottery method. In both groups, patients were compared for a reduction in HbA1c level after three months of treatment with Insulin. The efficacy was achieved after three months based on a>1% HbA1c level reduction compared to baseline HbA1c.
 Results: The efficacy of Glargine Insulin was found to be significantly higher, 66(66%), as compared to NPH Insulin, 43(43%) (p-value = 0.002). After adjusting for all other covariates, the efficacy of Glargine Insulin was 3.81 times higher as compared to NPH Insulin (aOR 3.81, 95% CI 1.93-7052). Furthermore, efficacy was 6.95 times higher in patients with ≤25 kg/m2 BMI (aOR 6.95, 95% CI 3.16-15.30), 2.52 times higher in patients with ≤16 years of type 2 diabetes (aOR 2.52, 95% CI 1.30-4.87), 2.77 times higher in patients living in urban areas (aOR 2.77, 95% CI 1.43-5.36).
 Conclusion: The efficacy of Glargine Insulin was found to be considerably higher than NPH Insulin in patients with type 2 diabetes not controlled with oral hypoglycemia.Keywords: Efficacy, Glargine insulin, NPH insulin, Type 2 diabetes.