Division of Nephrology, Department of Internal Medicine, Konya Numune State Hospital, Ferhuniye Mah. Hastane Cad., 42690, Konya, Turkey,
Clin Drug Investig. 2013 Oct;33(10):773-8. doi: 10.1007/s40261-013-0118-5.
Insulin detemir induces bodyweight loss or less weight gain in patients with type 2 diabetes mellitus. However, in contrast to insulin detemir, insulin glargine has no weight loss effect. Increased sodium excretion has been speculated to be one of the mechanisms of weight loss by insulin detemir. However, there are no studies in the literature comparing sodium excretion between patients using insulin detemir and those using insulin glargine. There are also no studies comparing the excretion of urinary albumin and urinary protein in chronic kidney disease (CKD) patients using insulin detemir or insulin glargine. Thus, the aim of the current study was to compare the effects of insulin detemir and insulin glargine on sodium, albumin, and protein excretion in patients with various stages of CKD and concomitant type 2 diabetes.
Demographic, clinical, and laboratory data were evaluated for all patients. Hypoglycemic attacks, appetite score, 24-h urinary sodium, albumin, and protein excretion were also measured.
A total of 47 patients (23 taking insulin detemir, 24 taking insulin glargine) were included in the study. There were no differences with respect to 24-h sodium (p = 0.694), albumin (p = 0.297), or protein excretion (p = 0.202) between patient groups. Appetite and hypoglycemic attacks also did not differ between groups. Use of insulin detemir or insulin glargine was not related to sodium, albumin, and protein excretion in stepwise regression analysis.
There was no difference between insulin detemir and insulin glargine with respect to sodium, albumin, and protein excretion in type 2 diabetic CKD patients. Studies are needed both in CKD patients and those with normal renal function to highlight mechanisms regarding the weight loss effect unique to insulin detemir.
胰岛素地特胰岛素可引起 2 型糖尿病患者体重减轻或体重增加较少。然而，与胰岛素地特胰岛素不同，胰岛素甘精没有减肥作用。人们推测，胰岛素地特胰岛素引起体重减轻的机制之一是增加钠排泄。然而，目前文献中尚无比较使用胰岛素地特胰岛素和胰岛素甘精的患者之间钠排泄的研究。也没有比较使用胰岛素地特胰岛素或胰岛素甘精的慢性肾脏病（CKD）患者尿白蛋白和尿蛋白排泄的研究。因此，本研究旨在比较胰岛素地特胰岛素和胰岛素甘精对不同 CKD 分期合并 2 型糖尿病患者钠、白蛋白和蛋白排泄的影响。
评估所有患者的人口统计学、临床和实验室数据。还测量了低血糖发作、食欲评分、24 小时尿钠、白蛋白和蛋白排泄。
共有 47 名患者（23 名接受胰岛素地特胰岛素治疗，24 名接受胰岛素甘精治疗）纳入研究。两组 24 小时钠（p = 0.694）、白蛋白（p = 0.297）或蛋白排泄（p = 0.202）无差异。两组之间的食欲和低血糖发作也没有差异。逐步回归分析显示，使用胰岛素地特胰岛素或胰岛素甘精与钠、白蛋白和蛋白排泄无关。
在 2 型糖尿病 CKD 患者中，胰岛素地特胰岛素与胰岛素甘精在钠、白蛋白和蛋白排泄方面没有差异。需要在 CKD 患者和肾功能正常的患者中进行研究，以突出胰岛素地特胰岛素特有的减肥作用的相关机制。
