Volume 20, Issue 3 (Paramedical Sciences and Military Health 2025)                   Paramedical Sciences and Military Health 2025, 20(3): 13-20 | Back to browse issues page

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Malek mohammadi R, Mosavi tadi V. Comparative effects of morning and bedtime insulin glargine administration on glucose profile in diabetes mellitus type II patients. Paramedical Sciences and Military Health 2025; 20 (3) :13-20
URL: http://jps.ajaums.ac.ir/article-1-499-en.html
Comparative effects of morning and bedtime insulin glargine administration on glucose profile in diabetes mellitus type II patients
Razie Malek mohammadi *1 , Vahid Mosavi tadi2
1- Department of Internal Medicine, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran. , r.malekmohammadi@gmail.com
2- Department of Endocrinology, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran.
Abstract:   (26 Views)
Introduction: The global prevalence of diabetes has risen substantially over the past decade. Insulin glargine 100 units/mL is widely used as a basal insulin therapy for patients with type 2 diabetes mellitus. One of its notable side effects is nocturnal hypoglycemia, which highlights the importance of appropriate timing of administration in effective disease management. This study aimed to compare the effects of morning versus evening administration of insulin glargine on glycemic profiles in patients with type 2 diabetes.
Materials and Methods: The present study is quasi-experimental research with a pretestposttest design that conducted on 40 patients with type 2 diabetes who attended the Endocrine Clinic of Imam Reza Hospital in Tehran between the years of 2023 and 2024. During the first phase, all participants received insulin glargine (100 units/mL) at bedtime for three months. In the subsequent three-month period, the same dose was administered in the morning. Patients' glucose and lipid profiles were evaluated at the end of each phase. Paired t-tests and Wilcoxon signed-rank tests were used for statistical analysis.
Results: The mean age of the study participants was 64.47 ± 59.7 years. There was a statistically significant reduction in the incidence of hypoglycemia with morning insulin glargine compared with evening insulin in all participants (P = 0.02). this issue was observed in women (P = 0.03) and it was observed in patients who were younger than 65 years (P = 0.04). Triglyceride levels with morning insulin were significantly higher in all patients (P = 0.04) including women (p=0.017) and patients who were younger than 65 years (p=0.008). Additionally, fasting blood sugar level in women (p=0.04) and blood sugar level 2 hours after fasting in those patients who were 65 or above (p=0.048) were higher with morning insulin.
Conclusion: Results indicated that there was a reduction in the incidence of hypoglycemia with morning insulin compared with evening insulin in patients with type 2 diabetes. However, there was not any significant differences in indicators of monitoring blood sugar. Moreover, evening insulin was accompanied with decreasing Triglyceride level. These results help optimize insulin injection timing and they provide a foundation for developing safer and more effective treatment strategies for patients with type 2 diabetes.
Keywords: Insulin glargine, Type 2 diabetes mellitus, Glycemic profile, Hypoglycemia, Injection timing, Morning vs bedtime insulin
     
Type of Study: Applicable | Subject: full articles
Received: 2025/08/23 | Accepted: 2025/09/24 | Published: 2025/10/2
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