Insulin Combination Therapy in Type 2 Diabetes Mellitus
Authors: Andreas Fritsche
Journal: Annals of Internal Medicine (2004)

Letters20 April 2004Insulin Combination Therapy in Type 2 Diabetes MellitusAndreas Fritsche, MD, Hans-Ulrich Häring, MD, and Matthias Axel Schweitzer, MDAndreas Fritsche, MDFrom Medizinische Universitätsklinik, D-72076 Tübingen, and Aventis Pharma Germany, D-65812 Bad Soden am Taunus, Germany.Search for more papers by this author, Hans-Ulrich Häring, MDFrom Medizinische Universitätsklinik, D-72076 Tübingen, and Aventis Pharma Germany, D-65812 Bad Soden am Taunus, Germany.Search for more papers by this author, and Matthias Axel Schweitzer, MDFrom Medizinische Universitätsklinik, D-72076 Tübingen, and Aventis Pharma Germany, D-65812 Bad Soden am Taunus, Germany.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-140-8-200404200-00025 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Drs. Hassan, Hassan, and Gupta and Drs. Mikhail and Wali criticize the open-label design of our study. However, when insulin glargine is compared with NPH insulin, blinding cannot be justified for several reasons. First, NPH insulin is a turbid suspension whereas insulin glargine is a clear solution. Therefore, patients can easily identify the type of insulin they are using whenever the cartridge is transparent (with or without lettering). Second, filling both insulins in nontransparent cartridges can result in the administration of an incorrect dose of insulin; patients must be aware of and in control of the level of ...References1. Jehle PM, Micheler C, Jehle DR, Breitig D, Boehm BO. Inadequate suspension of neutral protamine Hagendorn (NPH) insulin in pens. Lancet. 1999;354:1604-7. [PMID: 10560676] CrossrefMedlineGoogle Scholar2. Yki-Järvinen H, Häring HU, Johnson E, Arbet-Engels C, Nguyen HA, Zeger S, et al . The relationship between glycemic control and hypoglycaemia using insulin glargine versus NPH insulin: a meta-regression analysis in type 2 diabetes [Abstract]. Diabetes. 2003;52:A149-150. MedlineGoogle Scholar3. Stratton IM, Adler AI, Neil HA, Matthews DR, Manley SE, Cull CA, et al . Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. 2000;321:405-12. [PMID: 10938048] CrossrefMedlineGoogle Scholar4. Dailey G, Riddle M, Massi Benedetti M, Fritsche A, Lin Z, Salzman A. A meta-analysis of phase III/IIIb studies comparing insulin glargine with human NPH insulin in type 2 diabetes: severe hypoglycaemia is less common with insulin glargine [Abstract]. Diabetologia. 2003;46:A305. MedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Medizinische Universitätsklinik, D-72076 Tübingen, and Aventis Pharma Germany, D-65812 Bad Soden am Taunus, Germany. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoGlimepiride Combined with Morning Insulin Glargine, Bedtime Neutral Protamine Hagedorn Insulin, or Bedtime Insulin Glargine in Patients with Type 2 Diabetes Andreas Fritsche , Matthias Axel Schweitzer , Hans-Ulrich Hring , and Insulin Combination Therapy in Type 2 Diabetes Mellitus Yusuf Hassan , Gaurav Gupta , and Saira Hassan Insulin Combination Therapy in Type 2 Diabetes Mellitus Nasser Mikhail and Soma Wali Metrics 20 April 2004Volume 140, Issue 8Page: 667KeywordsAbsolute risk reductionHemoglobinHyperglycemiaHypoglycemiaHypoglycemicsInsulinProspective studiesType 2 diabetes ePublished: 20 April 2004 Issue Published: 20 April 2004 CopyrightCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...