Use of insulin glargine in Japanese patients with type 1 diabetes

To evaluate the results of treatment with an insulin glargine-based regimen as compared with those of an NPH insulin-based regimen.

We reviewed the charts of 83 Japanese patients with Type 1 diabetes treated with insulin glargine for 12 months.

Median age, 56.9 years (range, 24.6-74.8 years), mean (+/-S.D.) body mass index, 21.2 (+/-2.2) kg/m2.

The average HbA1c level of the cohort was 7.8 +/- 1.2% at baseline and 7.7 +/- 1.0% at the end of the 12-month treatment (P=0.34). The average insulin requirement per day in the cohort remained unchanged after the 12-month treatment (35.0 +/- 11.6 units/day versus 35.2 +/- 11.2 units/day (P=0.58). Of the 36 patients who were receiving twice or three times daily injections of NPH insulin, 30 could be switched to a single-daily injection of insulin glargine. The frequency of severe hypoglycemia with unconsciousness became lower after switching to the insulin glargine-based regimen than during treatment with the NPH-based regimen. The average ratio of the daily usage of insulin glargine to that of total insulin after 12 months was smaller than that reported from other countries (0.34 +/- 0.09).

These results obtained from a larger number of patients as compared to previous Japanese studies confirm earlier reports that insulin glargine provides equivalent glycemic control to human NPH insulin, with a lower incidence of severe hypoglycemia. Thus, treatment with insulin glargine provides some benefits to Japanese patients with Type 1 diabetes.