Effects of analogue insulin in multiple daily injection therapy of type 2 diabetes on postprandial glucose control and cardiac function compared to human insulin: a randomized controlled long-term study

Cardiovascular Diabetology
Helene von BibraPetra-Maria Schumm-Draeger

Abstract

The prevention of cardiovascular disease, including diastolic cardiac dysfunction with its high prevalence and ominous prognosis, is a therapeutic challenge for patients with type 2 diabetes. Both short and long-acting insulin analogues (AI) have been shown to reduce glucose variability and provide potential benefit for cardiovascular disease although the effects on cardiac function have not yet been evaluated. This long-term, prospective, randomized controlled trial in patients with type 2 diabetes (T2D) tested the hypothesis that a multiple daily injection regimen (MDI) with AI improves postmeal glucose excursions in comparison to human insulin (HI) and that the effects of AI improve diastolic cardiac function. For 36 months, MDI treatment in 109 T2D patients was adapted every 3 months (targets: fasting glucose ≤ 110 mg/dl, postmeal glucose ≤ 150 mg/dl) in both groups: AI (insulin detemir and insulin aspart, n = 61) and HI (NPH-insulin and regular HI, n = 48). Diastolic cardiac function (myocardial velocity E' using tissue Doppler imaging and the mitral inflow ratio E/A) and vascular function were assessed before and 2 h after a standardized breakfast (48 g carbohydrates). At baseline, both groups were comparable with regards...Continue Reading

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Citations

Nov 23, 2017·Journal of Diabetes and Metabolic Disorders·Shuang LiangXiaoquan Liu
Nov 9, 2017·Therapeutic Advances in Endocrinology and Metabolism·Christoph Hasslacher, Justo Lorenzo Bermejo
Dec 7, 2018·Journal of Diabetes Investigation·Kai-Jen TienWayne Huey-Herng Sheu
Apr 14, 2016·MMW Fortschritte der Medizin·Thorsten Siegmund
Jul 4, 2017·Indian Journal of Endocrinology and Metabolism·D C SharmaParminder Singh
Oct 21, 2016·Current Heart Failure Reports·Helene von BibraMartin St John Sutton
Jun 3, 2018·Hormones : International Journal of Endocrinology and Metabolism·Panagiotis AnagnostisAsterios Karagiannis

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Methods Mentioned

BETA
amputation

Software Mentioned

SPSS

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