Efficacy and Safety of Switching from Premix Twice Daily Injection to Sulfonylurea and Once Daily Insulin Glargine in Japanese Type 2 Diabetes (JUN-LAN Study 8)

Abstract

We have evaluated the efficacy and safety of switching from premix twice daily injection to basal supported oral therapy (BOT) sulfonylurea with once daily glargine in Japanese type 2 diabetes. Those whose HbA_1C was ≥7.0% over 6 months with premix twice daily injection underwent combined therapy with sulfonylurea and once daily insulin glargine at bed time or morning. After 24 weeks, mean HbA_1C improved significantly from 8.26±1.14% to 7.70±0.78%, as did fasting blood glucose from 155.1±38.7 mg/dl to 120.6±24.1 mg/dl. Total daily insulin dose decreased significantly from 0.42±0.20 U/kg of premix insulin to 0.34±0.19 U/kg of glargine. Hypoglycemic episodes in 5 subjects were mediated after decreasing the glimepiride dose. These results suggested that switching from premix twice daily to BOT was effective and safe, but more intensive therapy such as step-up bolus insulin addition to BOT was required for most subjects to be treated to the target.