In patients older than 65 with type 2 diabetes requiring insulin, insulin detemir may be a better choice than NPH insulin, based on an analysis of pooled data from randomized studies.In patients older than 65 with type 2 diabetes requiring insulin, insulin detemir may be a better choice than NPH insulin, based on an analysis of pooled data from randomized studies.
Dr. Alan J. Garber, lead investigator stated that, "The findings of the study show that there was less hypoglycemia with insulin detemir than with other basal insulins."
Dr. Garber of Baylor College of Medicine in Houston, Texas, and colleagues examined data from three open-label studies. These involved 416 subjects aged 65 years or more and 880 younger subjects. They were treated for 22 to 26 weeks with basal detemir or NPH, along with mealtime insulin or oral agents.
The level of glycemic control achieved was similar with both insulins and in both age groups. However, those in the insulin detemir groups gained significantly less body weight (about 1 kg) than did patients on NPH insulin.
Moreover, with insulin detemir, there was a significant risk reduction of 41% for all hypoglycemic episodes in the older group. The risk reduction in the younger group was 25%.
"This suggests," Dr. Garber concluded, "that insulin detemir may be a safer therapeutic choice in patients, such as the elderly, for whom hypoglycemia may produce serious complications."
J Am Geriatr Soc 2007;55:1735-1740.