Insulin analogues and severe hypoglycaemia in type 1 diabetes

P L Kristensen; L S Hansen; M J Jespersen; U Pedersen-Bjergaard; Henning Beck-Nielsen; J S Christiansen; K Nørgaard; H Perrild; Hans-Henrik Dyring Parving; B Thorsteinsson; Lise Tarnow

doi:10.1016/j.diabres.2011.10.046

Insulin analogues and severe hypoglycaemia in type 1 diabetes

P L Kristensen, L S Hansen, M J Jespersen, U Pedersen-Bjergaard, Henning Beck-Nielsen, J S Christiansen, K Nørgaard, H Perrild, Hans-Henrik Dyring Parving, B Thorsteinsson, Lise Tarnow

50 Citations (Scopus)

Abstract

Introduction: The effect of insulin analogues on glycaemic control is well-documented, whereas the effect on avoidance of severe hypoglycaemia remains tentative. We studied the frequency of severe hypoglycaemia in unselected patients with type 1 diabetes treated with insulin analogues, human insulin, or mixed regimens. Methods: A questionnaire was posted from six Danish diabetes clinics to 6112 unselected patients with type 1 diabetes and filled in by 3861 patients (63.2%). Primary endpoint was number of episodes of severe hypoglycaemia in the preceding year. Mild hypoglycaemia was also reported. Results: The frequency of severe hypoglycaemic episodes per patient-year in patients receiving long-acting insulin analogues was 1.47. ±. 0.18 versus 1.09. ±. 0.10 in patients on long-acting human insulin (. p=. 0.01). The frequency of severe hypoglycaemic episodes per patient-year was 1.09. ±. 0.11 in patients on short-acting insulin analogues versus 1.26. ±. 0.13 in patients on short-acting human insulin (. p=. 0.15), which was statistically significant in an adjusted analysis. Conclusions: Severe hypoglycaemia is more frequent in patients with type 1 diabetes treated with long-acting insulin analogues. Confounding by indication may be involved. Clinical intervention trials using insulin analogues in patients prone to severe hypoglycaemia are highly needed.

Original language	English
Journal	Diabetes Research and Clinical Practice
Volume	96
Issue number	1
Pages (from-to)	17-23
Number of pages	7
ISSN	0168-8227
DOIs	https://doi.org/10.1016/j.diabres.2011.10.046
Publication status	Published - Apr 2012

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10.1016/j.diabres.2011.10.046

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title = "Insulin analogues and severe hypoglycaemia in type 1 diabetes",

abstract = "Introduction: The effect of insulin analogues on glycaemic control is well-documented, whereas the effect on avoidance of severe hypoglycaemia remains tentative. We studied the frequency of severe hypoglycaemia in unselected patients with type 1 diabetes treated with insulin analogues, human insulin, or mixed regimens. Methods: A questionnaire was posted from six Danish diabetes clinics to 6112 unselected patients with type 1 diabetes and filled in by 3861 patients (63.2%). Primary endpoint was number of episodes of severe hypoglycaemia in the preceding year. Mild hypoglycaemia was also reported. Results: The frequency of severe hypoglycaemic episodes per patient-year in patients receiving long-acting insulin analogues was 1.47. ±. 0.18 versus 1.09. ±. 0.10 in patients on long-acting human insulin (. p=. 0.01). The frequency of severe hypoglycaemic episodes per patient-year was 1.09. ±. 0.11 in patients on short-acting insulin analogues versus 1.26. ±. 0.13 in patients on short-acting human insulin (. p=. 0.15), which was statistically significant in an adjusted analysis. Conclusions: Severe hypoglycaemia is more frequent in patients with type 1 diabetes treated with long-acting insulin analogues. Confounding by indication may be involved. Clinical intervention trials using insulin analogues in patients prone to severe hypoglycaemia are highly needed.",

author = "Kristensen, {P L} and Hansen, {L S} and Jespersen, {M J} and U Pedersen-Bjergaard and Henning Beck-Nielsen and Christiansen, {J S} and K N{\o}rgaard and H Perrild and Parving, {Hans-Henrik Dyring} and B Thorsteinsson and Lise Tarnow",

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doi = "10.1016/j.diabres.2011.10.046",

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T1 - Insulin analogues and severe hypoglycaemia in type 1 diabetes

AU - Kristensen, P L

AU - Hansen, L S

AU - Jespersen, M J

AU - Pedersen-Bjergaard, U

AU - Beck-Nielsen, Henning

AU - Christiansen, J S

AU - Nørgaard, K

AU - Perrild, H

AU - Parving, Hans-Henrik Dyring

AU - Thorsteinsson, B

AU - Tarnow, Lise

PY - 2012/4

Y1 - 2012/4

N2 - Introduction: The effect of insulin analogues on glycaemic control is well-documented, whereas the effect on avoidance of severe hypoglycaemia remains tentative. We studied the frequency of severe hypoglycaemia in unselected patients with type 1 diabetes treated with insulin analogues, human insulin, or mixed regimens. Methods: A questionnaire was posted from six Danish diabetes clinics to 6112 unselected patients with type 1 diabetes and filled in by 3861 patients (63.2%). Primary endpoint was number of episodes of severe hypoglycaemia in the preceding year. Mild hypoglycaemia was also reported. Results: The frequency of severe hypoglycaemic episodes per patient-year in patients receiving long-acting insulin analogues was 1.47. ±. 0.18 versus 1.09. ±. 0.10 in patients on long-acting human insulin (. p=. 0.01). The frequency of severe hypoglycaemic episodes per patient-year was 1.09. ±. 0.11 in patients on short-acting insulin analogues versus 1.26. ±. 0.13 in patients on short-acting human insulin (. p=. 0.15), which was statistically significant in an adjusted analysis. Conclusions: Severe hypoglycaemia is more frequent in patients with type 1 diabetes treated with long-acting insulin analogues. Confounding by indication may be involved. Clinical intervention trials using insulin analogues in patients prone to severe hypoglycaemia are highly needed.

AB - Introduction: The effect of insulin analogues on glycaemic control is well-documented, whereas the effect on avoidance of severe hypoglycaemia remains tentative. We studied the frequency of severe hypoglycaemia in unselected patients with type 1 diabetes treated with insulin analogues, human insulin, or mixed regimens. Methods: A questionnaire was posted from six Danish diabetes clinics to 6112 unselected patients with type 1 diabetes and filled in by 3861 patients (63.2%). Primary endpoint was number of episodes of severe hypoglycaemia in the preceding year. Mild hypoglycaemia was also reported. Results: The frequency of severe hypoglycaemic episodes per patient-year in patients receiving long-acting insulin analogues was 1.47. ±. 0.18 versus 1.09. ±. 0.10 in patients on long-acting human insulin (. p=. 0.01). The frequency of severe hypoglycaemic episodes per patient-year was 1.09. ±. 0.11 in patients on short-acting insulin analogues versus 1.26. ±. 0.13 in patients on short-acting human insulin (. p=. 0.15), which was statistically significant in an adjusted analysis. Conclusions: Severe hypoglycaemia is more frequent in patients with type 1 diabetes treated with long-acting insulin analogues. Confounding by indication may be involved. Clinical intervention trials using insulin analogues in patients prone to severe hypoglycaemia are highly needed.

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DO - 10.1016/j.diabres.2011.10.046

M3 - Journal article

C2 - 22136722

SN - 0168-8227

VL - 96

SP - 17

EP - 23

JO - Diabetes Research and Clinical Practice

JF - Diabetes Research and Clinical Practice

IS - 1

ER -

Insulin analogues and severe hypoglycaemia in type 1 diabetes

Abstract

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