Study: Analog Glulisine Improves Glycemic Control in Hospitalized Type 2 Diabetes Patients

According to the researchers, insulin therapy in hyperglycemic inpatients is difficult due to vacillating meal times in hospitals, irregular food intake, and medical conditions that can lead to hypoglycemia. Hence, they studied the benefit of rapid-acting insulin in this setting in 180 patients with Type 2 Diabetes who were admitted for non-critical medical or surgical care for at least 3 days.

The primary end points of the study were glycemic control, quantified by the mean daily blood glucose concentration and the incidence of hypoglycemia.

After being removed from any prior Diabetes medication, the patients were randomized in two groups to either rapid-acting glulisine (Apidra, Sanofi-Aventis) or regular insulin (Novolin R, Novo Nordisk) before meals, as well as insulin glargine (Lantus, Sanofi-Aventis) at bedtime.

Results: 

• For the first four days, the average blood glucose concentrations were the same, 159 mg/dL, in the both groups. 
• However, after four days, the concentration levels stood at 140 vs. 162 mg/dL (p<0.0007) in the glulisine and normal insulin groups, respectively. 
• After seven days, the levels were 133 vs. 164 mg/dL (p<0.0001) in the glulisine and normal insulin groups, respectively. 

For hypoglycemia, the study stated that "there were 123 hypoglycemic events: 56 in the glulisine group and 67 in the regular insulin group." However, Dr. Meyer and colleagues report, the number of subjects with one or more hypoglycemic episodes (30% vs. 35%, p>0.5) was not significantly different.

The researchers concluded, "The present study provides evidence suggesting that treatment with glulisine can provide superior glycemic control compared (to) regular insulin in hospitalized T2DM patients, especially in those who have a prolonged length of stay."