Progression was evaluated using the Early Treatment Diabetic Retinopathy Study (ETDRS) scale; the scores at study end were similar in both treatment groups (Lantus(R): 14.2%, NPH: 15.7%; 95% CI: -7.02, 3.06). As per protocol, the study aimed to achieve similar levels of glycemic control in both groups, in order to avoid introducing bias on the primary retinopathy end-point that could be related to differences in blood glucose control. Both groups had comparable HbA1c at study end (mean HbA1c improved from a baseline of 8.4% and 8.3% to 7.8% and 7.6% for all patients in the insuline glargine and NPH insulin groups respectively). NPH insulin was associated with a significantly greater incidence of severe hypoglycemia than was insulin glargine (11.1% vs 7.6% respectively, p=0.0439) and mean yearly rates of symptomatic hypoglycemia (7.08+/-16.49 vs 5.13+/-12.79, p=0.0017).
There was no observable trend for a difference in the incidence of serious adverse events including cancer, as well as adverse events leading to study withdrawal. The most common adverse events in the study were: upper respiratory tract infection (glargine 149 [29%], NPH 169 [33.6%]), peripheral edema (glargine 103 [20%], NPH 114 [22.7%]), and arthralgia (glargine 73 [14.2%], NPH 81 [16.1%]).
About the study
This long-term study was designed to further characterize the retinal safety profile of insulin glargine (glargine) and human neutral protamine Hagedorn insulin (NPH) in patients with type 2 diabetes mellitus.
This was an open-label, 5-year, randomized (1:1), multicentre, stratified, parallel-group study comparing patients treated with either twice-daily NPH (n=509) or once-daily basal glargine (n=515).
The main objective of this study was to compare the progression of diabetic retinopathy between treatment groups by analyzing the percentage of patients with greater than or equal to 3-st
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