Insulin determir (Levemir; Novo Nordisk), a long-acting new diabetes drug, effectively lowers blood sugar, as determined by hemoglobin A1c levels, and is associated with few episodes of low blood sugar (hypoglycemia) and minimal weight gain in type 2 diabetics, researchers reported this weekend at the 67th Scientific Sessions of the American Diabetes Association, underway in Chicago.

Principal investigator Dr. Luigi Meneghini of the Diabetes Research Institute in Miami presented the results of the study, which involved 5,603 type 2 diabetics who were treated with a starting dose of insulin determir once a day based on fasting blood glucose, with add-on therapy as needed.

Patients were randomly assigned to either self-adjusted dosing, according to instructions provided to them, or to physician-directed dosing instructions.

The average hemoglobin A1C levels decreased from 8.5 percent at the beginning of the study to 7.9 percent after 26 weeks for the self-adjusting patients and from 8.5 percent to 8.0 percent for patients under the physician-driven care plan.

The average daily detemir dose was 0.68 U/kg for the self-adjusting patients and 0.53 U/kg for the physician-directed group.

Body weight change over the study was negligible for both groups, with an increase of 0.1 kg for patients adjusting their own doses and a decrease of 0.2 kg for patients receiving physician-directed dosing.

The rates of hypoglycemia were very low in both groups, with 0.54 events per patient per month for self-adjusting patients and 0.41 events per patient per month in physician-directed patients.

Major hypoglycemic events were rare, at 0.02 events per patient per month for both groups.

At 26 weeks, 88 percent of all the patients remained on the once-daily detemir therapy.

"The study is a testament to the safety of Levemir," Meneghini said. "Since having type 2 diabetes requires a great deal of self-management, these findings will help empower patients to work more closely as partners with their physician to take control of their insulin treatment."