Efficacy of Glargine Insulin Compared with Neutral Protamine Hagedorn Insulin in Patients with Type 2 Diabetes not Controlled with Oral Hypoglycemics: A Cohort Study

Ebtihal Bilal; Shamaila Burney; Muhammad Usman Sajid; Nabila Shaukat; Muhammad Farooq

doi:10.51253/pafmj.v73i4.7183

Authors

Ebtihal Bilal Department of Medicine, Islamic International Medical College, Rawalpindi Pakistan
Shamaila Burney Department of Medicine, Islamic International Medical College, Rawalpindi Pakistan
Muhammad Usman Sajid Department of Medicine, Combined Military Hospital Jhelum/National University of Medical Sciences (NUMS) Pakistan
Nabila Shaukat Department of Medicine, DHQ Hospital Mirpur, Azad Jammu and Kashmir Pakistan
Muhammad Farooq Department of Medicine, Islamic International Medical College, Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v73i4.7183

Keywords:

Efficacy, Glargine insulin, NPH insulin, Type 2 diabetes

Abstract

Objective: To compare the efficacy of Glargine Insulin with Neutral Protamine Hagedorn (NPH) Insulin in patients with uncontrolled type 2 diabetes with oral hypoglycemic.

Study Design: Prospective cohort study.

Place and Duration of the Study: Railway Hospital, Rawalpindi Pakistan, from Nov 2020 to Jul 2021.

Methodology: All patients aged 30-70 years of either gender, presented with uncontrolled diabetes mellitus on oral hypoglycemic for ≥1 year were enrolled. Patients were divided into Insulin Glargine and injection NPH subcutaneously by lottery method. In both groups, patients were compared for a reduction in HbA1c level after three months of treatment with Insulin. The efficacy was achieved after three months based on a>1% HbA1c level reduction compared to baseline HbA1c.

Results: The efficacy of Glargine Insulin was found to be significantly higher, 66(66%), as compared to NPH Insulin, 43(43%) (p-value = 0.002). After adjusting for all other covariates, the efficacy of Glargine Insulin was 3.81 times higher as compared to NPH Insulin (aOR 3.81, 95% CI 1.93-7052). Furthermore, efficacy was 6.95 times higher in patients with ≤25 kg/m2 BMI (aOR 6.95, 95% CI 3.16-15.30), 2.52 times higher in patients with ≤16 years of type 2 diabetes (aOR 2.52, 95% CI 1.30-4.87), 2.77 times higher in patients living in urban areas (aOR 2.77, 95% CI 1.43-5.36).

Conclusion: The efficacy of Glargine Insulin was found to be considerably higher than NPH Insulin in patients with type 2 diabetes not controlled with oral hypoglycemia.
Keywords: Efficacy, Glargine insulin, NPH insulin, Type 2 diabetes.