Humalog® Mix50™ before carbohydrate-rich meals in type 2 diabetes mellitus

Paris Roach, V. Arora, B. N. Campaigne, V. Mattoo, S. Rangwala, Prasanna Kumar, Nadeem Rais, A. Ramachandran, C. B. Sridhar

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19 Scopus citations


Aim: To compare pre-meal injection of Humalog® Mix50™ (Mix50) and Humalog® Mix25™ (Humalog® Mix75/25™ in the US; Mix25) with respect to 2 h postprandial (2 h pp) blood glucose (BG) control after a carbohydrate-rich breakfast in patients with type 2 diabetes. Research Design and Methods: One hundred and sixteen patients were enrolled in a 16-week crossover trial and received two treatment regimens in a randomized crossover fashion: (i) Mix50 before breakfast and Mix25 before the evening meal (Mix50/Mix25) and (ii) Mix25 before both breakfast and the evening meal (Mix25 twice daily). Insulin doses were adjusted according to stated glycaemic targets. After 6 and 8 weeks of treatment, the patient's usual morning insulin dose was administered, followed immediately by a test breakfast representative of the patient's usual breakfast meal. Fasting and 2 h pp BG concentrations were measured at the time of the test meal. Haemoglobin A1c (A1C was measured, and information regarding hypoglycaemia (symptoms) was collected at the end of each treatment period. Results: Insulin doses were similar between treatments (morning = 31-33 U, evening = 26-28 U) at endpoint. Following the test breakfast, the 2 h pp BG was lower (10.9 ± 0.3 mmol/l vs. 12.4 ± 0.3 mmol/l, p = 0.0012) and the 2 h pp BG excursion was smaller (1.4 ± 0.28 mmol/l vs. 3.5 ± 0.28 mmol/l, p < 0.001) during treatment with Mix50/Mix25 than during treatment with Mix25 twice daily. There was no difference between the treatments with respect to fasting BG (Mix50/Mix25, 9.5 ± 0.3 mmol/l vs. Mix25 twice daily, 8.9 ± 0.3 mmol/l; p = NS), A1C (8.14% ± 1.14% vs. 8.14% ± 1.07%; p = NS) or the incidence of self-reported hypoglycaemia (34% vs. 23%; p = NS). Conclusions: Compared with treatment with Mix25 twice daily, treatment with Mix50 before breakfast and Mix25 before the evening meal resulted in better pp glycaemic control following a carbohydrate-rich meal, and similar fasting BG, A1C and incidence of hypoglycaemia in patients with type 2 diabetes.

Original languageEnglish (US)
Pages (from-to)311-316
Number of pages6
JournalDiabetes, Obesity and Metabolism
Issue number5
StatePublished - Sep 2003


  • High carbohydrate
  • Insulin lispro mixtures

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

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    Roach, P., Arora, V., Campaigne, B. N., Mattoo, V., Rangwala, S., Kumar, P., Rais, N., Ramachandran, A., & Sridhar, C. B. (2003). Humalog® Mix50™ before carbohydrate-rich meals in type 2 diabetes mellitus. Diabetes, Obesity and Metabolism, 5(5), 311-316.