Biphasic insulin aspart 70/30 three times a day in older patients with type 2 diabetes not achieving optimal glycemic control on a twice-daily regimen: A retrospective case series analysis from clinical practice
This retrospective study was conducted to determine whether the addition of a third injection of biphasic insulin aspart 70/30 (BIAsp 30) just before lunch in older patients with type 2 diabetes who did not achieve goals with a twice-daily (BID) regimen would optimize glycemic control in a clinical practice setting. A retrospective chart analysis was conducted. In 12 patients aged 52 to 80 y with type 2 diabetes that had been diagnosed between 5 and 24 y earlier and who remained on oral antidiabetes agents, a third injection of BIAsp 30 was added because optimal glycemic control (glycosylated hemoglobin [HbA1c] < 7%) was not achieved on a BID regimen. Changes in HbA1c, body weight, total insulin dose, and frequency of hypoglycemia were analyzed after 6 mo of three times daily (TID) treatment. Mean HbA1c decreased from 8.4% to 7.2%. An HbA1c goal of < 7% was attained by 58% of patients. Although the total insulin dose increased by 11% with the TID regimen, pre-breakfast and predinner doses decreased by 15%. No patient experienced major hypoglycemia on BID or TID dosing. With the TID regimen, no minor hypoglycemic events were reported by patients and mean body weight decreased by 2.25 lb. The addition of a third injection of BIAsp 30 substantially improved HbA1c and decreased body weight and the incidence of hypoglycemia in 12 patients with type 2 diabetes who did not achieve optimal glycemic control on a BID regimen.
Keywordspremixed insulin analog BIAsp 30 HbA1c hypoglycemia dosing
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- 3.Davidson JA, Blonde L, Jellinger PS, Lebovitz HE, Parkin CG. Road map for the prevention and treatment of type 2 diabetes.Endocr Pract. 2006;12:148.Google Scholar
- 5.Nathan DM, Buse JB, Davidson MB, et al. Management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy. A consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes.Diabetes Care. 2006;29:1963–1972.PubMedCrossRefGoogle Scholar
- 10.Korytkowski M, Bell D, Jacobsen C, Suwannasari R. A multicenter, randomized, open-label, comparative, two-period crossover trial of preference, efficacy, and safety profiles of a prefilled, disposable pen and conventional vial/syringe for insulin injection in patients with type 1 or 2 diabetes mellitus.Clin Ther. 2003;25:2836–2848.PubMedCrossRefGoogle Scholar
- 11.Rubin RR, Peyrot M. Quality of life, treatment satisfaction, and treatment preference associated with use of a pen device delivering a premixed 70/30 insulin aspart suspension (aspart protamine suspension/soluble aspart) versus alternative treatment strategies.Diabetes Care. 2004;27: 2495–2497.PubMedCrossRefGoogle Scholar
- 22.Roach P, Trautmann M, Arora V, Sun B, Anderson JH Jr. Improved postprandial blood glucose control and reduced nocturnal hypoglycemia during treatment with two novel insulin lisproprotamine formulations, insulin lispro mix25 and insulin lispro mix50. Mix50 Study Group.Clin Ther. 1999;21:523–534.PubMedCrossRefGoogle Scholar
- 23.Malone JK, Kerr LF, Campaigne BN, Sachson RA, Holcombe JH. Combined therapy with insulin lispro Mix 75/25 plus metformin or insulin glargine plus metformin: a 16-week, randomized, open-label, crossover study in patients with type 2 diabetes beginning insulin therapy.Clin Ther. 2004;26:2034–2044.PubMedCrossRefGoogle Scholar