Starting patients with type 2 diabetes on insulin therapy using once-daily injections of biphasic insulin aspart 70/30, biphasic human insulin 70/30, or NPH insulin in combination with metformin

• Published in: Journal of diabetes and its complications 2003-11, Vol.17 (6), p.307-313
• Main Authors: Kilo, Charles, Mezitis, Nicholas, Jain, Rajeev, Mersey, James, McGill, Janet, Raskin, Philip
• Format: Article
• Language: English
• Subjects: Administration, Oral; Adult; Biological and medical sciences; Biphasic insulin; Biphasic insulin aspart; Blood Glucose - analysis; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - drug therapy; Diabetes. Impaired glucose tolerance; Drug Administration Schedule; Drug Combinations; Drug Therapy, Combination; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Glycated Hemoglobin A - analysis; Humans; Hypoglycemic Agents - administration & dosage; Injections, Subcutaneous; Insulin; Insulin - administration & dosage; Insulin - analogs & derivatives; Insulin Aspart; Insulin initiation; Insulin, Isophane - administration & dosage; Male; Medical sciences; Metformin; Metformin - administration & dosage; Middle Aged; Treatment Outcome; Type 2 diabetes
• ISSN: 1056-8727; 1873-460X
• DOI: 10.1016/S1056-8727(03)00076-X

Transitioning safely to insulin therapy when oral antidiabetic agents fail to provide adequate glycemic control is a critical aspect of care for the patient with type 2 diabetes mellitus (T2DM). We evaluated the clinical effectiveness of starting patients on a relatively simple regimen of once-daily injections of either biphasic insulin aspart 70/30 (10 min before dinner), NPH insulin (at 10 p.m.), or biphasic human insulin 70/30 (30 min before dinner) in combination with metformin. Enrolled patients had T2DM and inadequate glycemic control (AlC≥7.5%) on a previous regimen of metformin as monotherapy or in combination with a sulphonylurea. One hundred and forty (140) patients received metformin monotherapy for 4 weeks followed by 12 weeks of combination treatment with metformin and once-daily insulin injections. AlC levels decreased from baseline by 1.1–1.3% for patients in each of the three treatment groups. Overall, FPG values decreased from baseline by 31% (biphasic insulin aspart), 37% (NPH insulin), and 28% (biphasic human insulin). Subjects whose final FPG level was