Endocrine Abstracts

Introduction: The advent of insulin analogs has significantly reduced the undesirable effects of human insulin, particularly hypoglycemia. Beneficial effects on the lipid balance have also been described. The aimof our study was to describe the evolution of the lipidic parameters after the switch on insulin analogs.

Patients and Methods: This is a longitudinal retrospective study about 61 patients with type 2 diabetes, switched to insulin analogs since at least 3 months. Clinical and biological data were taken from medical records. During the study, no modification or introduction of lipid-lowering therapy was made.

Results: The mean age was 60.7 ± 10.2 years. The sex ratio was 0.96. Diabetes had evolved for an average of 18.1 ± 8.9 years. Retinopathy and diabetic nephropathy were frequent by 49% and 41.7% respectively. The mean duration of insulin analog therapy was 17.33 ± 10.13 months. Determir was the most prescribed slow insulin analog (59%). Insulin Aspart was the most widely prescribed rapid insulin analog (76.8%). 82% of the patients were hypertensive. 85.2% were dyslipidemic. The mean CT and LDL levels decreased significantly during the 3 periods studied (CT (T0) = 4.9 mmol/l, CT at 3 months = 4.63 (P = 0.035), CT at 6 months = 4, 45 (P = 0.02), CT at one year = 4.25 (P = 0.017), (LDL (T0) = 3.2 mmol/l, LDL at 3 months = 2.98 (P = 0.012), LDL at 6 months = 2.75 (P = 0.003), LDL at 1 year = 2.5 (P = 0.001) The HDL level remained stable The TG level increased without reaching the significance level. The percentage of patients achieving the LDL objective was maximum at 1 year (T0: 18.2%, at 3 months: 31.4%, at 6 months: 37.1%, at 12 months: 55.6%). The percentage of patients achieving the HDL target remained stable (T0: 33.3%, at 3 months: 31.4%, at 6 months: 33.3%, at 12 months: 33.3%). The percentage of patients achieving the TG target was maximal at 1 year (T0: 68.5%, at 3 months: 71.4%, at 6 months: 69%, at 12 months: 73%).

Conclusion: The modification of the lipidic parameters after switching to insulin analogs had been reported in the literature. It was linked, among others, to the weight change. Studies on a larger scale are essential in order to better characterize the variation in the lipidic balance after switching to analogs and to identify the associated factors.