The Treat-to-Target Trial: Randomized addition of glargine or human NPH insulin to oral therapy of type 2 diabetic patients

摘要: OBJECTIVE —To compare the abilities and associated hypoglycemia risks of insulin glargine human NPH added to oral therapy type 2 diabetes achieve 7% HbA 1c . RESEARCH DESIGN AND METHODS —In a randomized, open-label, parallel, 24-week multicenter trial, 756 overweight men women with inadequate glycemic control (HbA >7.5%) on one or two agents continued prestudy received bedtime once daily, titrated using simple algorithm seeking target fasting plasma glucose (FPG) ≤100 mg/dl (5.5 mmol/l). Outcome measures were FPG, , hypoglycemia, percentage patients reaching ≤7% without documented nocturnal hypoglycemia. RESULTS —Mean FPG at end point was similar (117 vs. 120 [6.5 6.7 mmol/l]), as (6.96 6.97%). A majority (∼60%) attained each type. However, nearly 25% more this (≤72 [4.0 mmol/l]) (33.2 26.7%, P CONCLUSIONS —Systematically titrating basal can safely in between 7.5 10.0% alone. In doing this, causes significantly less than NPH, thus reducing leading barrier initiating insulin. This regimen may facilitate earlier effective use routine medical practice, improving achievement recommended standards care.