Yonsei Med J.  2010 Nov;51(6):845-849. 10.3349/ymj.2010.51.6.845.

Effects of Twice-Daily Injections of Premixed Insulin Analog on Glycemic Control in Type 2 Diabetic Patients

• Shimizu H
• Monden T
• Matsumura
• Domeki N
• Kasai K

• KMID: 1779629
• DOI: http://doi.org/10.3349/ymj.2010.51.6.845

Abstract

PURPOSE
Premixed insulin is effective to improve glycemic control; however, clinicians may be less likely to know which premixed insulin is appropriate for which patients. This study aimed to evaluate the effects of twice-daily injections of premixed insulin lispro on glycemic control in type 2 diabetic patients.
MATERIALS AND METHODS
Forty type 2 diabetic patients, who had been treated with twice-daily injections of human protamine mixture 30/70 insulin for at least 12 months, were divided into two groups; one group whose blood glucose 2 hours after breakfast was greater than 200 mg/dL, was switched to lispro mix50, and the other group whose blood glucose 2 hours after breakfast < 200 was switched to lispro mix25.
RESULTS
Glycated haemoglobin (HbA1c) significantly improved in the Mix50 group from 8.3% to 7.5% (at 12 weeks; p < 0.05), and to 7.5% (at 24 weeks; p < 0.05). On the other hand, HbA1c levels in the Mix25 group were slightly decreased from 8.1% to 7.7% at 12 weeks (p < 0.05), and to 7.9% at 24 weeks (not significant). Both postprandial plasma glucose and fasting plasma glucose levels were significantly improved in the Mix50 group, but not in the Mix25 group. Overall, 95% of subjects preferred premixed lispro insulin from human insulin in the viewpoint of the timing of insulin injection by questionnaire analysis.
CONCLUSION
Switching from human protamine mixture 30/70 insulin to lispro mix50 twice-daily injection therapy in patients with high postprandial plasma glucose could improve their glycemic control and quality of life.

Keyword

Type 2 diabetes; postprandial hyperglycemia; lispro Mix50; lispro Mix25

MeSH Terms

Aged
Blood Glucose/*analysis
Body Mass Index
Body Weight
Diabetes Mellitus, Type 2/*drug therapy
Female
Hemoglobin A, Glycosylated/metabolism
Humans
Insulin/administration & dosage/*analogs & derivatives
Male
Middle Aged
Postprandial Period
Protamines/administration & dosage
Treatment Outcome

Figure

• 

  Fig. 1 Effects of Mix25 and Mix50 treatment on fasting and postprandial plasma glucose. Values are the mean ± SD. *p < 0.05 vs. baseline. PG, plasma glucose; PPG, postprandial plasma glucose; FPG, fasting plasma glucose.

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