Researchers report a low incidence of severe nocturnal hypoglycemia in patients with Type 1 diabetes treated with insulin glargine in combination with either regular human insulin or insulin lispro.

Long-acting insulin analogs such as insulin glargine may help reduce the high risk for nocturnal hypoglycemia associated with neutral protamine Hagedorn (NPH) insulin, a basal insulin commonly used by patients with Type 1 diabetes.

Paolo Brunetti (University of Perugia, Italy) and co-workers investigated the effects of combining regular human insulin or insulin lispro with insulin glargine on the incidence of severe nocturnal hypoglycemia.

They explain that regular human insulin has a longer duration of action compared with insulin lispro, and would therefore be expected to induce a higher risk for nocturnal hypoglycemia.

Patients with Type 1 diabetes using NPH insulin or insulin glargine were switched to, or continued on, insulin glargine for 8 weeks. The authors then randomly assigned 395 patients to insulin lispro or regular human insulin at each meal for 16 weeks; patients continued to receive insulin glargine at dinner time.

Seven-point self-monitored blood glucose profiles were taken. Hypoglycemia was assessed throughout the study and categorized according to blood glucose levels as mild (60-72 mg/dl), symptomatic (42??”59 mg/dl), or severe (less than 41 mg/dl).

As reported in the journal Nutrition, Metabolism & Cardiovascular Diseases, a low rate of severe nocturnal hypoglycemia was observed, with three (1.55%) patients in the regular human insulin group and two (1.11%) in the insulin lispro group experiencing the event. The primary endpoint of the study, non-inferiority of regular human insulin compared with insulin lispro, was therefore demonstrated.

There was also no difference in the incidence of overall hypoglycemia with 2.85 episodes per patient a month reported for both groups.

Glycated hemoglobin (HbA1c) levels were significantly reduced with both insulin glargine combinations with no significant difference between the groups. However, mean levels of fasting plasma glucose were slightly lower in the regular human insulin group than in the insulin lispro group at the end of the study.

The authors reported a trend for lower post-prandial blood glucose levels in the lispro group compared with the regular human insulin group, but the latter tended to have lower pre-prandial blood glucose levels compared with the lispro group, suggesting that meal time doses of both bolus insulins should be managed with care.

The authors acknowledge that further studies with larger sample sizes are necessary to verify their findings. But they conclude: “Insulin glargine in combination with a short-acting analog or regular human insulin is associated with a similar and low rate of nocturnal hypoglycemia and glycemic control.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009

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Well documented facts of how garlic helps the diabetic by improving blood sugar control, lower cholesterol and blood pressure, and other vascular risk factors makes it an important part of the control of diabetes. It really is a wonder drug that is cheap and plentiful.

The best way to get the benefits of garlic is to use it liberally in your cooking. Getting the taste for garlic has more benefits then I can list in this article. Once you develop your eating habits around garlic, you will not cook without it.

If you would rather get the benefits of garlic in pill form, you will have to watch out to make sure you’re getting all the promised results. Manufacturers coat the prepared garlic in such a way that the tablet does not break down until it has passed through the stomach. This is called enteric coating.

There are a couple of things to look for when choosing a garlic product. It is important to make sure the tablet provides a sufficient level of allicin, important for control of blood sugar.

Next, if the quality of the enteric coating is not right, the allicin will not be liberated at the proper time in the small intestine. 75% of the tested brands of garlic tablets on the market released less than 10% of their label claim of allicin.

The studies showing a positive effect of garlic tablets are those that deliver a sufficient dosage of allicin.

There are two brands that use the USP method to ensure label claims for allicin potential. Garlicin {Nature’s Way} and Garlic Factors {Natural Factors}. I recommend one of these two brands if you want to see results.

Almost 30 percent of the US population has what is called pre-diabetes. If left unchecked, it will become type 2 diabetes in about ten years or less in most people. Even young people are now being found with pre-diabetes.

Why is this happening at such an alarming rate? Family history is the blame for some of it, but for the most part it is our easy lifestyle and high intake of sugar and processed food. Just fifty years ago our diet was mainly some meat, vegetables, and maybe some type of potatoes.

Just look at any photo of a street load of people taken in the forties or fifties and count the overweight people. Then walk down town and try to count them. You will have to count fast.

Proper nutrition and physical activity can do wonders for the pre-diabetic to prolong the onset of type 2 diabetes and even prevent it altogether. Just losing ten pounds and doing exercises daily cuts the chance of getting diabetes by fifty percent.

As far as a diet for the prevention of diabetes goes, mainly it should include lots of fruits, vegetables, and whole grains. Limit soft drinks, juice, and anything with white flour and sugar. Surprisingly ice cream isn’t that bad. It’s very important to never skip a meal.

Muscle burns calories, so some weight training should be combined with aerobics and stretching for a good workout several times a week. Staying active by getting out of the house for walks etc. are very important. Staying really active will burn fat and keep your outlook better both mentally and physically.