Optimized glycaemic control achieved with add-on basal insulin therapy improves indexes of @entity16 and regeneration in type 2 XXXX @entity1 with macroangiopathy: a randomized crossover trial comparing detemir versus glargine.

@entity2175 @entity1 @entity6 @entity4725 @entity16 @entity4105 @entity1017 @entity2071 @entity65
AIMS: In @entity6 , @entity16 promotes macroangiopathy and endothelial regeneration is impaired, owing to reduced endothelial progenitor cells (EPCs). Given that insulin influences endothelial biology, we compared the effects of add-on basal insulin analogues on @entity16 and regeneration in @entity2175 ( @entity2175 ). METHODS: This was a 6-month randomized crossover trial comparing add-on insulin detemir versus glargine in poorly controlled @entity2175 with macroangiopathy. At baseline, crossover (3 months) and study end (6 months), we measured HbA1c, EPCs, circulating endothelial cells (CECs), @entity4725 , @entity2071 and @entity4105 . Body weight and hypoglycaemic episodes were also recorded. RESULTS: Forty-two @entity1 completed the study, randomly assigned to the glargine-detemir (n = 21) or the detemir-glargine (n = 21) schedule. At crossover, EPC levels did not change compared with baseline, but significantly increased at study end. CECs decreased over time and were significantly reduced at study end. @entity2071 , @entity4725 and @entity4105 were significantly reduced at crossover and further decreased at study end. No differences were seen in these effects between detemir and glargine. HbA1c showed a carryover effect and its reduction was similar with detemir and glargine in the first arm. Incidence of hypoglycaemia and @entity1017 was lower with detemir than with glargine in both arms. CONCLUSION: Optimized glycaemic control by add-on basal insulin improved indexes of @entity16 and regeneration. Compared to glargine, detemir achieved similar endothelial protection with lower @entity1017 and less hypoglycaemia. These results might have implications for therapy of aging @entity2175 @entity1 with @entity65 .
