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    Comparison of efficacy and safety of once- versus twice-daily insulin detemir added on to oral antidiabetics in insulin-naive type 2 diabetes patients: 24-Week, crossover, treat to target trial in a single center
    (Elsevier, 2014-01-18) Cander, Soner; Dizdar, Oğuzhan Sıtkı; Öz Gül, Özen; Güçlü, Metin; Ünal, Oǧuz Kaan; Tuncel, Ercan; Ertürk, Erdinç; İmamoğlu, Şazi; Ersoy, Canan Özyardımcı; Uludağ Üniversitesi/Tıp Fakültesi/Endokrinoloji ve Metabolizma Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.; 0000-0001-5082-9894; AAJ-6536-2021; AAH-8861-2021; AAI-1005-2021; ABI-4847-2020; 25027068600; 55202193000; 26040787100; 15073842600; 55042241400; 7006929833; 7005488796; 6602297533; 6701485882
    Aim: To compare once- versus twice-daily insulin detemir added on OADS therapy in insulin-naive type 2 diabetes patients in terms of efficacy and safety. Methods: An open-label study performed at a single center, comprised a randomized, crossover 24 week with insulin-naive type 2 diabetes patients. Insulin detemir was initiated with mean 0.12 U/kg in all patients (Group I once-daily, Group II twice-daily) and titrated for 24 week. Results: A total of 50 patients completed the study (Group I n:25, Group II n:25). With use of once- and twice-daily insulin, HbA1c values were decreased by 1.8% (+/- 2.0) and 1.5% (+/- 1.4) within the first 12 weeks (p<0.01), whereas increased by 0.21% (+/- 0.7) and 0.14% (+/- 0.8) in the second 12 weeks (p>0.05). The increases in the insulin doses were found as 0.22 U/kg and 0.35 U/kg with once- and twice-daily insulin use, respectively (p:0.04). Although minor hypoglycemic events were similar in both groups in the first 12 weeks, 2-fold increase was found in the patients shifting from once- to twice-daily dose. Within the first and second periods, the body weight of the patients was observed an increase of 0.4 and 1.6 kg with once-daily dose, whereas a decrease of 0.1 and 2.1 kg in the twice-daily dose, in the same period. Conclusion: Once-daily use of insulin detemir up to 0.4 U/kg was found to have similar efficacy and safety as twice-daily use. Twice dose use of insulin did not provide a prominent glycemic control advantage on 1.5-fold higher use of insulin.