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Hypoglycemia is a common problem in patients with type 2 diabetes. The relationship between the use of intermediate-acting insulin analogues and the occurrence of hypoglycemia is not well documented. Aims To examine whether or not the use of intermediate-acting insulin analogues increases the incidence of symptomatic hypoglycemia in patients with newly diagnosed type 2 diabetes. We used a database of the Stockholm Diabetes Register to identify patients with newly diagnosed type 2 diabetes (n = 577) who had been prescribed NPH or glargine as their initial insulin. The occurrence of symptomatic hypoglycemia (SH) was ascertained during a mean follow-up period of 5.8 years. We used a Cox regression model to estimate the association between hypoglycemia and insulin analogues. Compared with patients prescribed NPH insulin, those prescribed glargine had a 1.9-fold increased risk of developing SH (adjusted hazard ratio, 1.9; 95% CI, 1.4-2.7). Adjusting for potential confounding factors and insulin dose did not materially alter this estimate. Furthermore, glargine was associated with an increased occurrence of SH among all patients, whether they were elderly (aged 70 years or older), young (aged or=30 kg/m2). Our data indicate that intermediate-acting insulin analogues may be associated with an increased risk of SH. The underlying mechanisms require further elucidation., 87, 103, 100?
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