Endocrine Abstracts

Introduction: Glargine is an analogue insulin with a flat pharmacokinetic profile and duration of action of 24 h providing stable ‘background’ insulin on which fast acting insulin can be added during meal times. Clinical trials have indicated that this leads to more satisfactory and stable glycaemic control with reduced frequency of hypoglycaemia. We carried out a prospective audit to see if these reported benefits are confirmed in routine clinical practice.

Methods: adults with Diabetes Mellitus on an insulin regimen were changed over to a regimen including Glargine between September 2002 and September 2003 and were monitored over a period of 12 months. They included 96 patients with Type 1 Diabetes and 27 patients with Type 2 Diabetes. Indications for transferring to Glargine were: poor control (34%), hypoglycaemia (40%), nocturnal hypoglycaemia (25%), patient’s choice (1%).

Results: Median HbA1c improved significantly from 9% to 8.5% (P=0.001). The frequency of hypoglycaemia was significantly reduced following the conversion to Glargine (from 49 to 16, P<0.001) and the frequency of nocturnal hypoglycaemia was reduced in 20 of 30 patients. However, there was a small but significant increase in body weight with the median Body Mass Index increasing from 25.5 to 26.5 (P <0.001).

Conclusion: Introducing Glargine led to a significant improvement in glycaemic control and a reduction in the frequency of hypoglycaemia. Patients, particularly those working shifts, also reported an improvement of quality of life. There was however a rise in Body Mass Index.