How Do Glargine and Detemir Compare with NPH Insulin in a Real-World Setting?

The marked rise in cost of insulin analogs prompted this retrospective study of specific hypoglycemia-related events and glycemic control in patients taking insulin analogs (glargine [Lantus] or detemir [Levemir]) compared with those taking neutral protamine Hagedorn (NPH) insulin. Using data from Kaiser Permanente of Northern California (an integrated healthcare system), researchers identified more than 25,000 patients (mean age, 60) with type 2 diabetes who initiated basal insulin between 2006 and 2014. Because NPH has been the first-line basal insulin for type 2 diabetes in this healthcare system (in contrast to preferential prescribing of insulin analogs in most of the U.S.), 92% of patients in this cohort used NPH insulin and only 8% u…