Comparison of insulin lispro mixture 25/75 with insulin glargine during a 24-h standardized test-meal period in patients with Type 2 diabetes

Paris Roach, J. K. Malone

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15 Citations (Scopus)

Abstract

Aims: To compare insulin lispro mixture (25% insulin lispro and 75% NPL; Mix 25/75) twice-daily plus oral glucose-lowering medications (metformin and/or sulphonylurea) with once-daily insulin glargine plus oral agents with respect to postprandial glycaemic control and other glucose and lipid parameters in patients with Type 2 diabetes inadequately controlled with insulin and/or oral glucose-lowering agents. Methods: This was a randomized, open-label, crossover study. Prestudy oral agents were continued and patients not already on oral agents were treated with metformin. Mix 25/75 and insulin glargine were adjusted over 3 months to attain premeal plasma glucose (PG) < 6.0 mmol/l and were then given during a 24-h in-patient test meal period with frequent PG, serum triglyceride (TG) and free fatty acid (FFA) measurements. Results: Twenty patients (10 F/10 M; mean ± sd age 54.0 ± 10.7 years, body mass index 37.0 ± 8.6 kg/m2, HbA1c 8.4 ± 1.01%) participated. Mean doses were 23 U before the morning and 37 U before the evening meal for Mix 25/75 and 44 U for insulin glargine. The combined 2-h morning and evening meal postprandial plasma glucose (PPG) was not different between groups (9.2 ± 2.04 vs. 9.9 ± 1.66 mmol/l, P = 0.161). Mix 25/75 was associated with a lower mean 2-h PPG for all meals combined (9.0 ± 1.88 vs. 9.9 ± 1.80 mmol/l, P < 0.05) and lower mean 24-h PG (6.7 ± 1.00 vs. 7.5 ± 1.32 mmol/l, P < 0.01). Eight patients experienced mild hypoglycaemia (PG < 3.5 mmol/l) with Mix 25/75 and 3 with insulin glargine. The endpoint HbA1c was lower with Mix 25/75 (6.9 ± 0.52% vs. 7.3 ± 0.81%, P < 0.05). Conclusions: In a 24-h test-meal setting in 20 patients, Mix 25/75 insulin plus oral glucose-lowering agents was associated with lower mean PPG and 24-h PG, more mild hypoglycaemia and similar TG, FFA and fasting PG concentrations. HbA1c was lower with Mix 75/25 plus oral agents, although it may not have reached steady state due to ongoing dose adjustment.

Original languageEnglish
Pages (from-to)743-749
Number of pages7
JournalDiabetic Medicine
Volume23
Issue number7
DOIs
StatePublished - Jul 2006

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Insulin Lispro
Biphasic Insulins
Type 2 Diabetes Mellitus
Meals
Glucose
Metformin
Hypoglycemia
Nonesterified Fatty Acids
Insulin Glargine
Triglycerides
Insulin
Social Adjustment
Breakfast

Keywords

  • Glargine
  • Insulin analogues
  • Lispro
  • Postprandial glucose
  • Standardized test meal

ASJC Scopus subject areas

  • Endocrinology
  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

@article{8c664865f0724abfaba6b616253e774b,
title = "Comparison of insulin lispro mixture 25/75 with insulin glargine during a 24-h standardized test-meal period in patients with Type 2 diabetes",
abstract = "Aims: To compare insulin lispro mixture (25{\%} insulin lispro and 75{\%} NPL; Mix 25/75) twice-daily plus oral glucose-lowering medications (metformin and/or sulphonylurea) with once-daily insulin glargine plus oral agents with respect to postprandial glycaemic control and other glucose and lipid parameters in patients with Type 2 diabetes inadequately controlled with insulin and/or oral glucose-lowering agents. Methods: This was a randomized, open-label, crossover study. Prestudy oral agents were continued and patients not already on oral agents were treated with metformin. Mix 25/75 and insulin glargine were adjusted over 3 months to attain premeal plasma glucose (PG) < 6.0 mmol/l and were then given during a 24-h in-patient test meal period with frequent PG, serum triglyceride (TG) and free fatty acid (FFA) measurements. Results: Twenty patients (10 F/10 M; mean ± sd age 54.0 ± 10.7 years, body mass index 37.0 ± 8.6 kg/m2, HbA1c 8.4 ± 1.01{\%}) participated. Mean doses were 23 U before the morning and 37 U before the evening meal for Mix 25/75 and 44 U for insulin glargine. The combined 2-h morning and evening meal postprandial plasma glucose (PPG) was not different between groups (9.2 ± 2.04 vs. 9.9 ± 1.66 mmol/l, P = 0.161). Mix 25/75 was associated with a lower mean 2-h PPG for all meals combined (9.0 ± 1.88 vs. 9.9 ± 1.80 mmol/l, P < 0.05) and lower mean 24-h PG (6.7 ± 1.00 vs. 7.5 ± 1.32 mmol/l, P < 0.01). Eight patients experienced mild hypoglycaemia (PG < 3.5 mmol/l) with Mix 25/75 and 3 with insulin glargine. The endpoint HbA1c was lower with Mix 25/75 (6.9 ± 0.52{\%} vs. 7.3 ± 0.81{\%}, P < 0.05). Conclusions: In a 24-h test-meal setting in 20 patients, Mix 25/75 insulin plus oral glucose-lowering agents was associated with lower mean PPG and 24-h PG, more mild hypoglycaemia and similar TG, FFA and fasting PG concentrations. HbA1c was lower with Mix 75/25 plus oral agents, although it may not have reached steady state due to ongoing dose adjustment.",
keywords = "Glargine, Insulin analogues, Lispro, Postprandial glucose, Standardized test meal",
author = "Paris Roach and Malone, {J. K.}",
year = "2006",
month = "7",
doi = "10.1111/j.1464-5491.2006.01895.x",
language = "English",
volume = "23",
pages = "743--749",
journal = "Diabetic Medicine",
issn = "0742-3071",
publisher = "Wiley-Blackwell",
number = "7",

}

TY - JOUR

T1 - Comparison of insulin lispro mixture 25/75 with insulin glargine during a 24-h standardized test-meal period in patients with Type 2 diabetes

AU - Roach, Paris

AU - Malone, J. K.

PY - 2006/7

Y1 - 2006/7

N2 - Aims: To compare insulin lispro mixture (25% insulin lispro and 75% NPL; Mix 25/75) twice-daily plus oral glucose-lowering medications (metformin and/or sulphonylurea) with once-daily insulin glargine plus oral agents with respect to postprandial glycaemic control and other glucose and lipid parameters in patients with Type 2 diabetes inadequately controlled with insulin and/or oral glucose-lowering agents. Methods: This was a randomized, open-label, crossover study. Prestudy oral agents were continued and patients not already on oral agents were treated with metformin. Mix 25/75 and insulin glargine were adjusted over 3 months to attain premeal plasma glucose (PG) < 6.0 mmol/l and were then given during a 24-h in-patient test meal period with frequent PG, serum triglyceride (TG) and free fatty acid (FFA) measurements. Results: Twenty patients (10 F/10 M; mean ± sd age 54.0 ± 10.7 years, body mass index 37.0 ± 8.6 kg/m2, HbA1c 8.4 ± 1.01%) participated. Mean doses were 23 U before the morning and 37 U before the evening meal for Mix 25/75 and 44 U for insulin glargine. The combined 2-h morning and evening meal postprandial plasma glucose (PPG) was not different between groups (9.2 ± 2.04 vs. 9.9 ± 1.66 mmol/l, P = 0.161). Mix 25/75 was associated with a lower mean 2-h PPG for all meals combined (9.0 ± 1.88 vs. 9.9 ± 1.80 mmol/l, P < 0.05) and lower mean 24-h PG (6.7 ± 1.00 vs. 7.5 ± 1.32 mmol/l, P < 0.01). Eight patients experienced mild hypoglycaemia (PG < 3.5 mmol/l) with Mix 25/75 and 3 with insulin glargine. The endpoint HbA1c was lower with Mix 25/75 (6.9 ± 0.52% vs. 7.3 ± 0.81%, P < 0.05). Conclusions: In a 24-h test-meal setting in 20 patients, Mix 25/75 insulin plus oral glucose-lowering agents was associated with lower mean PPG and 24-h PG, more mild hypoglycaemia and similar TG, FFA and fasting PG concentrations. HbA1c was lower with Mix 75/25 plus oral agents, although it may not have reached steady state due to ongoing dose adjustment.

AB - Aims: To compare insulin lispro mixture (25% insulin lispro and 75% NPL; Mix 25/75) twice-daily plus oral glucose-lowering medications (metformin and/or sulphonylurea) with once-daily insulin glargine plus oral agents with respect to postprandial glycaemic control and other glucose and lipid parameters in patients with Type 2 diabetes inadequately controlled with insulin and/or oral glucose-lowering agents. Methods: This was a randomized, open-label, crossover study. Prestudy oral agents were continued and patients not already on oral agents were treated with metformin. Mix 25/75 and insulin glargine were adjusted over 3 months to attain premeal plasma glucose (PG) < 6.0 mmol/l and were then given during a 24-h in-patient test meal period with frequent PG, serum triglyceride (TG) and free fatty acid (FFA) measurements. Results: Twenty patients (10 F/10 M; mean ± sd age 54.0 ± 10.7 years, body mass index 37.0 ± 8.6 kg/m2, HbA1c 8.4 ± 1.01%) participated. Mean doses were 23 U before the morning and 37 U before the evening meal for Mix 25/75 and 44 U for insulin glargine. The combined 2-h morning and evening meal postprandial plasma glucose (PPG) was not different between groups (9.2 ± 2.04 vs. 9.9 ± 1.66 mmol/l, P = 0.161). Mix 25/75 was associated with a lower mean 2-h PPG for all meals combined (9.0 ± 1.88 vs. 9.9 ± 1.80 mmol/l, P < 0.05) and lower mean 24-h PG (6.7 ± 1.00 vs. 7.5 ± 1.32 mmol/l, P < 0.01). Eight patients experienced mild hypoglycaemia (PG < 3.5 mmol/l) with Mix 25/75 and 3 with insulin glargine. The endpoint HbA1c was lower with Mix 25/75 (6.9 ± 0.52% vs. 7.3 ± 0.81%, P < 0.05). Conclusions: In a 24-h test-meal setting in 20 patients, Mix 25/75 insulin plus oral glucose-lowering agents was associated with lower mean PPG and 24-h PG, more mild hypoglycaemia and similar TG, FFA and fasting PG concentrations. HbA1c was lower with Mix 75/25 plus oral agents, although it may not have reached steady state due to ongoing dose adjustment.

KW - Glargine

KW - Insulin analogues

KW - Lispro

KW - Postprandial glucose

KW - Standardized test meal

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U2 - 10.1111/j.1464-5491.2006.01895.x

DO - 10.1111/j.1464-5491.2006.01895.x

M3 - Article

C2 - 16842478

AN - SCOPUS:33748549978

VL - 23

SP - 743

EP - 749

JO - Diabetic Medicine

JF - Diabetic Medicine

SN - 0742-3071

IS - 7

ER -