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The researchers found that there were 39 hypoglycemia-related emergency department visits or hospital admissions among 1,928 patients who initiated insulin analogs, compared with 354 hypoglycemia-related emergency department visits or hospital admissions among 23,561 patients who initiated NPH insulin (11.9 versus 8.8 events per 1,000 person-years) during a mean follow-up of 1.7 years (between-group difference, 3.1 events per 1,000 person-years; 95 percent confidence interval, −1.5 to 7.7; P = 0.07).
For NPH insulin, the concentration of insulin crystals increases with insulin concentration with delayed SC absorption as a result [34].
Lower within-subject variability of insulin detemir in comparison to NPH insulin and insulin glargine in people with type 1 diabetes.
The total sample size for our study based on these criteria required 90 T2DM patients treated with NPH insulin and 90 with IG.
Basal insulin glargine (HOE 901) versus NPH insulin in patients with type 1 diabetes on multiple daily insulin regimens.
NPH insulin is intermediate acting and can be mixed with short-acting insulins so as to cover the immediate meal and the subsequent meal.
Furthermore, compared with NPH insulin, the absorption rate is significantly slower with approximately 50% of the injected dose of insulin glargine still detectable after 24 hours compared with approximately 20% of the NPH insulin dose (12).
His insulin regimen included insulin glargine 26 units subcutaneous (SC) daily at bedtime, NPH insulin 20 to 26 units SC daily at bedtime depending on his finger stick blood glucose level and the amount of dextrose in his dialysate, and insulin aspart for hyperglycemia correction as needed (typically once daily postdinner).
"And really," he added in an interview after the meeting, "there's no evidence that glargine (Lantus) offers any benefit over NPH insulin--and NPH insulin is cheaper."
A 26-week, randomized, parallel, treat-to-target trial comparing insulin detemir with NPH insulin as add on therapy to oral glucose-lowering drugs in insulin naive people with type 2 diabetes.
Some providers consider NPH insulin a basal insulin as well, but it is not used as often because of its erratic peaks and valleys.
NPH insulin has an onset of action of about two hours, a peak between four to 10 hours and duration of about 16 hours.
In studies lasting about 24 weeks, the risk for cancers of all types among 3,983 patients with either type 1 or type 2 diabetes on detemir was 0.36 per 1,000 person-years of exposure, compared with 0.92 for 2,661 similar patients using NPH insulin.