Insulin Therapy with Glargine for Type 1 Diabetes in Japanese Adults

Abstract

We examined the efficacy of conversion from NPH insulin to glargine in Japanese type 1 diabetic adults using basal/bolus therapy. Retrospective chart analysis was done for 41 patients 12 months after switching to insulin glargine therapy. Insulin glargine was well tolerated with less frequent unrecognized hypoglycemia. After 6 months, the average HbA₁c in the entire cohort dropped from 7.87±1.20% to 7.29±1.09% (p<0.01) but returned to initial levels after 12 months (7.87±1.03%, p>0.05). After the 12 months, the average insulin requirement per day of the cohort decreased from 37.4±13.9 units to 35.7±12.9 units (p<0.01). Of 25 patients injecting NPH insulin two or three times a day, 18 patients switched to single daily injections of insulin glargine. The average ratio of daily insulin glargine use to that of total insulin after 12 months was 0.35±0.09, similar to other reports from Japan, but smaller than that reported from other countries. Small body mass index (mean±S.D. 21.9±2.20 kg/m²) and a diet rich in carbohydrates among Japanese may require less basal insulin and more bolus insulin to control glycemia in Japanese patients with type 1 diabetes in adults.