The therapeutic effect of insulin glargine versu NPH insulin as add-on therapy to previous acarbose or metformin in senile obese type 2 diabetics

Objective To study the effectiveness and safety of insulin glargine versus isophane insulin as add-on therapy to previous OHA in senile obese type 2 diabetic patients who failed to control their blood glucose with oral hypoglycemic agents(OHA).Methods Sixty-one patients who failed to control their blood glucose with OHA were randomized into insulin glargine group and isophane insulin group.They were administered previous acarbose and/or metformin tablet and insulin glargine or isophand insulin as add-on therapy.The observation lasted for 12 weeks.Result(1) Both groups showed significant difference in HbA1c,FPG,and 2 hPG compared with before treatment,and in HbA1c and 2 hPG between the two groups(all P0.05);while there was no significant difference in FPG between the two groups(P0.05).(2) The BMI of the insulin glargine group was reduced by 2.7 kg/m2 compared with before treatment,while that of the isophand insulin group was basically unchanged compared with before treatment.(3) The 45.2% of patients with insulin glargine treatment and the 73.3% of patients with isophand insulin treatment had symptomatic hypoglycemia,and the difference was statistically significant(P0.05).(4) At the end of treatment,the dose of insulin glargine group and isophand insulin group was(18.7±3.5) U/d and(26.0±3.7) U/d respectively,and the difference was statistically significant(P0.05).Conclusion The combination of insulin glargine with acarbose and/or metformin is effective in controlling the blood glucose,decreasing the incidence of hypoglycemia, and controlling the body weight of senile obese type 2 diabetic patients.