schliessen

Filtern

 

Bibliotheken

Basal insulin glargine and microvascular outcomes in dysglycaemic individuals: results of the Outcome Reduction with an Initial Glargine Intervention (ORIGIN) trial

Aims/hypothesis As glycaemia and the incidence of microvascular diabetes complications follow a log-linear relationship, it becomes increasingly difficult to demonstrate a microvascular benefit of glucose-lowering when the HbA 1c level is close to normal. Methods The Outcome Reduction with an Initia... Full description

Journal Title: Diabetologia 2014, Vol.57 (7), p.1325-1331
Main Author: Gilbert, Richard E
Other Authors: Mann, Johannes F. E , Hanefeld, Markolf , Spinas, Giatgen , Bosch, Jackie , Yusuf, Salim , Gerstein, Hertzel C
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: Berlin/Heidelberg: Springer Berlin Heidelberg
ID: ISSN: 0012-186X
Zum Text:
SendSend as email Add to Book BagAdd to Book Bag
Staff View
recordid: cdi_proquest_miscellaneous_1535212255
title: Basal insulin glargine and microvascular outcomes in dysglycaemic individuals: results of the Outcome Reduction with an Initial Glargine Intervention (ORIGIN) trial
format: Article
creator:
  • Gilbert, Richard E
  • Mann, Johannes F. E
  • Hanefeld, Markolf
  • Spinas, Giatgen
  • Bosch, Jackie
  • Yusuf, Salim
  • Gerstein, Hertzel C
subjects:
  • 610 Medicine & health
  • Aged
  • Albuminuria - etiology
  • Albuminuria - prevention & control
  • Article
  • Associated diseases and complications
  • Biological and medical sciences
  • Blood Glucose
  • Clinic for Endocrinology
  • Dextrose
  • Diabetes Mellitus, Type 2 - blood
  • Diabetes Mellitus, Type 2 - complications
  • Diabetes Mellitus, Type 2 - drug therapy
  • Diabetes. Impaired glucose tolerance
  • Diabetic nephropathies
  • Diabetology
  • Endocrine pancreas. Apud cells (diseases)
  • Endocrinopathies
  • Etiopathogenesis. Screening. Investigations. Target tissue resistance
  • Female
  • Glucose
  • Glucose Intolerance - blood
  • Glucose Intolerance - complications
  • Glucose Intolerance - drug therapy
  • Glucose metabolism
  • Glycated Hemoglobin A
  • Human Physiology
  • Humans
  • Hypoglycemic Agents - pharmacology
  • Hypoglycemic Agents - therapeutic use
  • Insulin
  • Insulin Glargine
  • Insulin, Long-Acting - pharmacology
  • Insulin, Long-Acting - therapeutic use
  • Internal Medicine
  • Kidneys
  • Male
  • Medical sciences
  • Medicine
  • Medicine & Public Health
  • Metabolic Diseases
  • Middle Aged
  • Nephrology. Urinary tract diseases
  • Ophthalmology
  • Retinopathies
  • Treatment Outcome
  • Urinary system involvement in other diseases. Miscellaneous
ispartof: Diabetologia, 2014, Vol.57 (7), p.1325-1331
description: Aims/hypothesis As glycaemia and the incidence of microvascular diabetes complications follow a log-linear relationship, it becomes increasingly difficult to demonstrate a microvascular benefit of glucose-lowering when the HbA 1c level is close to normal. Methods The Outcome Reduction with an Initial Glargine Intervention (ORIGIN) trial randomised 12,537 people with diabetes, impaired glucose tolerance or impaired fasting glucose to receive standard glycaemic care or standard care with the addition of basal insulin glargine (A21Gly,B31Arg,B32Arg human insulin), targeting a fasting plasma glucose level ≤5.3 mmol/l. Microvascular outcomes during a median follow-up of 6.2 years were examined in participants whose baseline HbA 1c was above or below the median of 6.4% (46.4 mmol/mol). Results Allocation to the insulin glargine group reduced the incidence of the primary microvascular composite outcome of kidney and eye disease in participants whose baseline HbA 1c level was ≥6.4% (46.4 mmol/mol; HR 0.90 [95% CI 0.81, 0.99]) but not in participants with a lower baseline HbA 1c (HR 1.07 [95% CI 0.95, 1.20]; p value for interaction 0.031). In people whose baseline HbA 1c level was ≥6.4% (46.4 mmol/mol), the median post-randomisation change in HbA 1c was −0.65% (interquartile range −0.16, −0.91%) after allocation to insulin glargine and −0.33% (−0.83, 0.13%) after allocation to standard care (median HbA 1c difference 0.33%; p  
language: eng
source:
identifier: ISSN: 0012-186X
fulltext: no_fulltext
issn:
  • 0012-186X
  • 1432-0428
url: Link


@attributes
NO1
SEARCH_ENGINEprimo_central_multiple_fe
SEARCH_ENGINE_TYPEPrimo Central Search Engine
RANK2.5604677
LOCALfalse
PrimoNMBib
record
control
sourceidgale_opena
recordidTN_cdi_proquest_miscellaneous_1535212255
sourceformatXML
sourcesystemPC
galeidA370865922
sourcerecordidA370865922
originalsourceidFETCH-LOGICAL-1581t-bbc8747afd8ce510ab382268f8a4409b66420abfa3d6bd1416be5e457bc0dd9e0
addsrcrecordideNp9klFr1TAUx4sobk4_gC8SEGE-dCZp0ub6NoduF4aDoeBbOE1O7zJ6ky1JJ_s-flBT7zbnUOlD6cnv_z_nNP-qesnoHqO0e5coZVzWlIm64Y2qxaNqm4mG11Rw9bjano9rptpvW9WzlM4ppY0U7dNqi4uuY3RBt6sfHyDBSJxP0-g8WY0QV84jAW_J2pkYriCZqVRJmLIJa0yFJfY6rcZrA1iQ8m3dlbMTjOk9iViMciJhIPkMyclGRE7RTia74Ml3l8-KO1l6l13pfHjbcekzxiv0v6jdk9Pl4fLzW5JjgZ5XT4biji9u3jvV108fvxwc1ccnh8uD_eOaScVy3fdGdaKDwSqDklHoG8V5qwYFQtBF37aCl-IAjW17ywRre5QoZNcbau0C6U51tPENF-jBRdQX0a0hXusATluPWQerlZLaiF6AhUHKRTNQKltmBgaWWsCu4dAWq92N1UUMlxOmrNcuGRxH8BimpJlsJGecS1nQ1w_Q8zBFXxadKSEkk_wetYIRtfNDyBHMbKr3m46qVi44L9TeX6jy2PmqgsfBlfofArYRlKtOKeJwtzKjeg6Z3oRMl5DpOWRaFM2rm4Gnfo32TnGbqgK8uQFKeGAcInjj0m9OybZcz7xT96C5cRnmAJSp3fjfEfhGmYqpX2G898_-KfoJDBr69Q
sourcetypeOpen Access Repository
isCDItrue
recordtypearticle
pqid1534451525
display
typearticle
titleBasal insulin glargine and microvascular outcomes in dysglycaemic individuals: results of the Outcome Reduction with an Initial Glargine Intervention (ORIGIN) trial
creatorGilbert, Richard E ; Mann, Johannes F. E ; Hanefeld, Markolf ; Spinas, Giatgen ; Bosch, Jackie ; Yusuf, Salim ; Gerstein, Hertzel C
creatorcontribGilbert, Richard E ; Mann, Johannes F. E ; Hanefeld, Markolf ; Spinas, Giatgen ; Bosch, Jackie ; Yusuf, Salim ; Gerstein, Hertzel C ; ORIGIN trial investigators ; The ORIGIN trial investigators
descriptionAims/hypothesis As glycaemia and the incidence of microvascular diabetes complications follow a log-linear relationship, it becomes increasingly difficult to demonstrate a microvascular benefit of glucose-lowering when the HbA 1c level is close to normal. Methods The Outcome Reduction with an Initial Glargine Intervention (ORIGIN) trial randomised 12,537 people with diabetes, impaired glucose tolerance or impaired fasting glucose to receive standard glycaemic care or standard care with the addition of basal insulin glargine (A21Gly,B31Arg,B32Arg human insulin), targeting a fasting plasma glucose level ≤5.3 mmol/l. Microvascular outcomes during a median follow-up of 6.2 years were examined in participants whose baseline HbA 1c was above or below the median of 6.4% (46.4 mmol/mol). Results Allocation to the insulin glargine group reduced the incidence of the primary microvascular composite outcome of kidney and eye disease in participants whose baseline HbA 1c level was ≥6.4% (46.4 mmol/mol; HR 0.90 [95% CI 0.81, 0.99]) but not in participants with a lower baseline HbA 1c (HR 1.07 [95% CI 0.95, 1.20]; p value for interaction 0.031). In people whose baseline HbA 1c level was ≥6.4% (46.4 mmol/mol), the median post-randomisation change in HbA 1c was −0.65% (interquartile range −0.16, −0.91%) after allocation to insulin glargine and −0.33% (−0.83, 0.13%) after allocation to standard care (median HbA 1c difference 0.33%; p  < 0.0001). A smaller median difference of 0.22% was noted in people whose baseline HbA 1c was <6.4% ( p  < 0.0001). Conclusions/interpretation In patients with dysglycaemia, intervention targeting normal fasting glucose levels reduced HbA 1c and attenuated the risk of microvascular outcomes in participants with a baseline HbA 1c level ≥6.4% (46.4 mmol/mol). A neutral effect was seen in those with a lower baseline HbA 1c level. Trial registration: ClinicalTrials.gov NCT00069784
identifier
0ISSN: 0012-186X
1EISSN: 1432-0428
2DOI: 10.1007/s00125-014-3238-4
3PMID: 24771090
languageeng
publisherBerlin/Heidelberg: Springer Berlin Heidelberg
subject610 Medicine & health ; Aged ; Albuminuria - etiology ; Albuminuria - prevention & control ; Article ; Associated diseases and complications ; Biological and medical sciences ; Blood Glucose ; Clinic for Endocrinology ; Dextrose ; Diabetes Mellitus, Type 2 - blood ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - drug therapy ; Diabetes. Impaired glucose tolerance ; Diabetic nephropathies ; Diabetology ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; Female ; Glucose ; Glucose Intolerance - blood ; Glucose Intolerance - complications ; Glucose Intolerance - drug therapy ; Glucose metabolism ; Glycated Hemoglobin A ; Human Physiology ; Humans ; Hypoglycemic Agents - pharmacology ; Hypoglycemic Agents - therapeutic use ; Insulin ; Insulin Glargine ; Insulin, Long-Acting - pharmacology ; Insulin, Long-Acting - therapeutic use ; Internal Medicine ; Kidneys ; Male ; Medical sciences ; Medicine ; Medicine & Public Health ; Metabolic Diseases ; Middle Aged ; Nephrology. Urinary tract diseases ; Ophthalmology ; Retinopathies ; Treatment Outcome ; Urinary system involvement in other diseases. Miscellaneous
ispartofDiabetologia, 2014, Vol.57 (7), p.1325-1331
rights
0Springer-Verlag Berlin Heidelberg 2014
12015 INIST-CNRS
2COPYRIGHT 2014 Springer
lds50peer_reviewed
citedbyFETCH-LOGICAL-1581t-bbc8747afd8ce510ab382268f8a4409b66420abfa3d6bd1416be5e457bc0dd9e0
citesFETCH-LOGICAL-1581t-bbc8747afd8ce510ab382268f8a4409b66420abfa3d6bd1416be5e457bc0dd9e0
links
openurl$$Topenurl_article
thumbnail$$Usyndetics_thumb_exl
backlink
0$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=28565105$$DView record in Pascal Francis
1$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24771090$$D View this record in MEDLINE/PubMed
search
creatorcontrib
0Gilbert, Richard E
1Mann, Johannes F. E
2Hanefeld, Markolf
3Spinas, Giatgen
4Bosch, Jackie
5Yusuf, Salim
6Gerstein, Hertzel C
7ORIGIN trial investigators
8The ORIGIN trial investigators
title
0Basal insulin glargine and microvascular outcomes in dysglycaemic individuals: results of the Outcome Reduction with an Initial Glargine Intervention (ORIGIN) trial
1Diabetologia
addtitle
0Diabetologia
1Diabetologia
descriptionAims/hypothesis As glycaemia and the incidence of microvascular diabetes complications follow a log-linear relationship, it becomes increasingly difficult to demonstrate a microvascular benefit of glucose-lowering when the HbA 1c level is close to normal. Methods The Outcome Reduction with an Initial Glargine Intervention (ORIGIN) trial randomised 12,537 people with diabetes, impaired glucose tolerance or impaired fasting glucose to receive standard glycaemic care or standard care with the addition of basal insulin glargine (A21Gly,B31Arg,B32Arg human insulin), targeting a fasting plasma glucose level ≤5.3 mmol/l. Microvascular outcomes during a median follow-up of 6.2 years were examined in participants whose baseline HbA 1c was above or below the median of 6.4% (46.4 mmol/mol). Results Allocation to the insulin glargine group reduced the incidence of the primary microvascular composite outcome of kidney and eye disease in participants whose baseline HbA 1c level was ≥6.4% (46.4 mmol/mol; HR 0.90 [95% CI 0.81, 0.99]) but not in participants with a lower baseline HbA 1c (HR 1.07 [95% CI 0.95, 1.20]; p value for interaction 0.031). In people whose baseline HbA 1c level was ≥6.4% (46.4 mmol/mol), the median post-randomisation change in HbA 1c was −0.65% (interquartile range −0.16, −0.91%) after allocation to insulin glargine and −0.33% (−0.83, 0.13%) after allocation to standard care (median HbA 1c difference 0.33%; p  < 0.0001). A smaller median difference of 0.22% was noted in people whose baseline HbA 1c was <6.4% ( p  < 0.0001). Conclusions/interpretation In patients with dysglycaemia, intervention targeting normal fasting glucose levels reduced HbA 1c and attenuated the risk of microvascular outcomes in participants with a baseline HbA 1c level ≥6.4% (46.4 mmol/mol). A neutral effect was seen in those with a lower baseline HbA 1c level. Trial registration: ClinicalTrials.gov NCT00069784
subject
0610 Medicine & health
1Aged
2Albuminuria - etiology
3Albuminuria - prevention & control
4Article
5Associated diseases and complications
6Biological and medical sciences
7Blood Glucose
8Clinic for Endocrinology
9Dextrose
10Diabetes Mellitus, Type 2 - blood
11Diabetes Mellitus, Type 2 - complications
12Diabetes Mellitus, Type 2 - drug therapy
13Diabetes. Impaired glucose tolerance
14Diabetic nephropathies
15Diabetology
16Endocrine pancreas. Apud cells (diseases)
17Endocrinopathies
18Etiopathogenesis. Screening. Investigations. Target tissue resistance
19Female
20Glucose
21Glucose Intolerance - blood
22Glucose Intolerance - complications
23Glucose Intolerance - drug therapy
24Glucose metabolism
25Glycated Hemoglobin A
26Human Physiology
27Humans
28Hypoglycemic Agents - pharmacology
29Hypoglycemic Agents - therapeutic use
30Insulin
31Insulin Glargine
32Insulin, Long-Acting - pharmacology
33Insulin, Long-Acting - therapeutic use
34Internal Medicine
35Kidneys
36Male
37Medical sciences
38Medicine
39Medicine & Public Health
40Metabolic Diseases
41Middle Aged
42Nephrology. Urinary tract diseases
43Ophthalmology
44Retinopathies
45Treatment Outcome
46Urinary system involvement in other diseases. Miscellaneous
issn
00012-186X
11432-0428
fulltextfalse
rsrctypearticle
creationdate2014
recordtypearticle
recordideNp9klFr1TAUx4sobk4_gC8SEGE-dCZp0ub6NoduF4aDoeBbOE1O7zJ6ky1JJ_s-flBT7zbnUOlD6cnv_z_nNP-qesnoHqO0e5coZVzWlIm64Y2qxaNqm4mG11Rw9bjano9rptpvW9WzlM4ppY0U7dNqi4uuY3RBt6sfHyDBSJxP0-g8WY0QV84jAW_J2pkYriCZqVRJmLIJa0yFJfY6rcZrA1iQ8m3dlbMTjOk9iViMciJhIPkMyclGRE7RTia74Ml3l8-KO1l6l13pfHjbcekzxiv0v6jdk9Pl4fLzW5JjgZ5XT4biji9u3jvV108fvxwc1ccnh8uD_eOaScVy3fdGdaKDwSqDklHoG8V5qwYFQtBF37aCl-IAjW17ywRre5QoZNcbau0C6U51tPENF-jBRdQX0a0hXusATluPWQerlZLaiF6AhUHKRTNQKltmBgaWWsCu4dAWq92N1UUMlxOmrNcuGRxH8BimpJlsJGecS1nQ1w_Q8zBFXxadKSEkk_wetYIRtfNDyBHMbKr3m46qVi44L9TeX6jy2PmqgsfBlfofArYRlKtOKeJwtzKjeg6Z3oRMl5DpOWRaFM2rm4Gnfo32TnGbqgK8uQFKeGAcInjj0m9OybZcz7xT96C5cRnmAJSp3fjfEfhGmYqpX2G898_-KfoJDBr69Q
startdate20140426
enddate20140426
creator
0Gilbert, Richard E
1Mann, Johannes F. E
2Hanefeld, Markolf
3Spinas, Giatgen
4Bosch, Jackie
5Yusuf, Salim
6Gerstein, Hertzel C
general
0Springer Berlin Heidelberg
1Springer
2Springer Nature B.V
scope
0IQODW
1CGR
2CUY
3CVF
4ECM
5EIF
6NPM
7AAYXX
8CITATION
9BSHEE
103V.
117T5
127X7
137XB
1488E
158AO
168C1
178FI
188FJ
198FK
20ABUWG
21BENPR
22FYUFA
23GHDGH
24H94
25K9.
26M0S
27M1P
28PQEST
29PQQKQ
30PQUKI
31PRINS
327X8
33CLFQK
sort
creationdate20140426
titleBasal insulin glargine and microvascular outcomes in dysglycaemic individuals: results of the Outcome Reduction with an Initial Glargine Intervention (ORIGIN) trial
authorGilbert, Richard E ; Mann, Johannes F. E ; Hanefeld, Markolf ; Spinas, Giatgen ; Bosch, Jackie ; Yusuf, Salim ; Gerstein, Hertzel C
facets
frbrtype5
frbrgroupidcdi_FETCH-LOGICAL-1581t-bbc8747afd8ce510ab382268f8a4409b66420abfa3d6bd1416be5e457bc0dd9e0
rsrctypearticles
prefilterarticles
languageeng
creationdate2014
topic
0610 Medicine & health
1Aged
2Albuminuria - etiology
3Albuminuria - prevention & control
4Article
5Associated diseases and complications
6Biological and medical sciences
7Blood Glucose
8Clinic for Endocrinology
9Dextrose
10Diabetes Mellitus, Type 2 - blood
11Diabetes Mellitus, Type 2 - complications
12Diabetes Mellitus, Type 2 - drug therapy
13Diabetes. Impaired glucose tolerance
14Diabetic nephropathies
15Diabetology
16Endocrine pancreas. Apud cells (diseases)
17Endocrinopathies
18Etiopathogenesis. Screening. Investigations. Target tissue resistance
19Female
20Glucose
21Glucose Intolerance - blood
22Glucose Intolerance - complications
23Glucose Intolerance - drug therapy
24Glucose metabolism
25Glycated Hemoglobin A
26Human Physiology
27Humans
28Hypoglycemic Agents - pharmacology
29Hypoglycemic Agents - therapeutic use
30Insulin
31Insulin Glargine
32Insulin, Long-Acting - pharmacology
33Insulin, Long-Acting - therapeutic use
34Internal Medicine
35Kidneys
36Male
37Medical sciences
38Medicine
39Medicine & Public Health
40Metabolic Diseases
41Middle Aged
42Nephrology. Urinary tract diseases
43Ophthalmology
44Retinopathies
45Treatment Outcome
46Urinary system involvement in other diseases. Miscellaneous
toplevelpeer_reviewed
creatorcontrib
0Gilbert, Richard E
1Mann, Johannes F. E
2Hanefeld, Markolf
3Spinas, Giatgen
4Bosch, Jackie
5Yusuf, Salim
6Gerstein, Hertzel C
7ORIGIN trial investigators
8The ORIGIN trial investigators
collection
0Pascal-Francis
1Medline
2MEDLINE
3MEDLINE (Ovid)
4MEDLINE
5MEDLINE
6PubMed
7CrossRef
8Academic OneFile (A&I only)
9ProQuest Central (Corporate)
10Immunology Abstracts
11Health & Medical Collection
12ProQuest Central (purchase pre-March 2016)
13Medical Database (Alumni Edition)
14ProQuest Pharma Collection
15Public Health Database
16Hospital Premium Collection
17Hospital Premium Collection (Alumni Edition)
18ProQuest Central (Alumni) (purchase pre-March 2016)
19ProQuest Central (Alumni Edition)
20ProQuest Central
21Health Research Premium Collection
22Health Research Premium Collection (Alumni)
23AIDS and Cancer Research Abstracts
24ProQuest Health & Medical Complete (Alumni)
25Health & Medical Collection (Alumni Edition)
26Medical Database
27ProQuest One Academic Eastern Edition
28ProQuest One Academic
29ProQuest One Academic UKI Edition
30ProQuest Central China
31MEDLINE - Academic
32OpenAIRE
jtitleDiabetologia
delivery
delcategoryRemote Search Resource
fulltextno_fulltext
addata
au
0Gilbert, Richard E
1Mann, Johannes F. E
2Hanefeld, Markolf
3Spinas, Giatgen
4Bosch, Jackie
5Yusuf, Salim
6Gerstein, Hertzel C
aucorp
0ORIGIN trial investigators
1The ORIGIN trial investigators
formatjournal
genrearticle
ristypeJOUR
atitleBasal insulin glargine and microvascular outcomes in dysglycaemic individuals: results of the Outcome Reduction with an Initial Glargine Intervention (ORIGIN) trial
jtitleDiabetologia
stitleDiabetologia
addtitleDiabetologia
date2014-04-26
risdate2014
volume57
issue7
spage1325
epage1331
pages1325-1331
issn0012-186X
eissn1432-0428
abstractAims/hypothesis As glycaemia and the incidence of microvascular diabetes complications follow a log-linear relationship, it becomes increasingly difficult to demonstrate a microvascular benefit of glucose-lowering when the HbA 1c level is close to normal. Methods The Outcome Reduction with an Initial Glargine Intervention (ORIGIN) trial randomised 12,537 people with diabetes, impaired glucose tolerance or impaired fasting glucose to receive standard glycaemic care or standard care with the addition of basal insulin glargine (A21Gly,B31Arg,B32Arg human insulin), targeting a fasting plasma glucose level ≤5.3 mmol/l. Microvascular outcomes during a median follow-up of 6.2 years were examined in participants whose baseline HbA 1c was above or below the median of 6.4% (46.4 mmol/mol). Results Allocation to the insulin glargine group reduced the incidence of the primary microvascular composite outcome of kidney and eye disease in participants whose baseline HbA 1c level was ≥6.4% (46.4 mmol/mol; HR 0.90 [95% CI 0.81, 0.99]) but not in participants with a lower baseline HbA 1c (HR 1.07 [95% CI 0.95, 1.20]; p value for interaction 0.031). In people whose baseline HbA 1c level was ≥6.4% (46.4 mmol/mol), the median post-randomisation change in HbA 1c was −0.65% (interquartile range −0.16, −0.91%) after allocation to insulin glargine and −0.33% (−0.83, 0.13%) after allocation to standard care (median HbA 1c difference 0.33%; p  < 0.0001). A smaller median difference of 0.22% was noted in people whose baseline HbA 1c was <6.4% ( p  < 0.0001). Conclusions/interpretation In patients with dysglycaemia, intervention targeting normal fasting glucose levels reduced HbA 1c and attenuated the risk of microvascular outcomes in participants with a baseline HbA 1c level ≥6.4% (46.4 mmol/mol). A neutral effect was seen in those with a lower baseline HbA 1c level. Trial registration: ClinicalTrials.gov NCT00069784
copBerlin/Heidelberg
pubSpringer Berlin Heidelberg
pmid24771090
doi10.1007/s00125-014-3238-4