Improved glycaemic control without increased risk of hypoglycaemia with a 25% insulin/lispro 75% npl mixture twice daily compared with NPH twice daily in patients with type 2 diabetes

J. Reviriego, M. Herz, Paris Roach

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Twice-daily NPH monotherapy is commonly prescribed in type 2 diabetes, but it lacks short-or rapid-acting insulin to address postprandial blood glucose (pp BG). Humalog® Mix25 (Mix25) provides both intermediate-and rapid-acting insulin and may offer a therapeutic advantage. In an open-label crossover study, 66 patients with type 2 diabetes were randomly assigned to twice-daily Mix25 or NPH for 3 months, followed by the alternate treatment for 3 months. Primary outcomes were 7-point self-monitored BG profiles, HbA1c, hypoglycaemic rate, and insulin doses. Two-hour pp BG excursions and absolute BG values 2 hours after breakfast and dinner, before lunch, and at 3 am were found to be significantly lower during Mix25 treatment; the fasting BG level was significantly higher. Mean HbA1c was also significantly lower after Mix25 therapy (8.36% versus 8.59%; P=0.043). Hypoglycaemia and total daily insulin dose were not significantly different between treatments. In conclusion, compared with twice-daily NPH, twice-daily Mix25 at similar doses resulted in lower BG excursions after breakfast and dinner, lower BG concentrations at 4 of 7 points on the BG profile, a lower HbA1c, and no increase in hypoglycaemia. Mix25 may be a desirable alternative to NPH for type 2 diabetic patients using twice-daily insulin therapy.

Original languageEnglish
Pages (from-to)3-9
Number of pages7
JournalJournal of Applied Therapeutic Research
Volume4
Issue number4
StatePublished - 2004

Fingerprint

Insulin Lispro
Hypoglycemia
Type 2 Diabetes Mellitus
Short-Acting Insulin
Breakfast
Insulin
Meals
Blood Glucose
Therapeutics
Lunch
Hypoglycemic Agents
Cross-Over Studies
Fasting

Keywords

  • Glycaemic control
  • Humalog® Mix25
  • Insulin lispro
  • Type 2 diabetes

ASJC Scopus subject areas

  • Pharmacology

Cite this

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title = "Improved glycaemic control without increased risk of hypoglycaemia with a 25{\%} insulin/lispro 75{\%} npl mixture twice daily compared with NPH twice daily in patients with type 2 diabetes",
abstract = "Twice-daily NPH monotherapy is commonly prescribed in type 2 diabetes, but it lacks short-or rapid-acting insulin to address postprandial blood glucose (pp BG). Humalog{\circledR} Mix25™ (Mix25) provides both intermediate-and rapid-acting insulin and may offer a therapeutic advantage. In an open-label crossover study, 66 patients with type 2 diabetes were randomly assigned to twice-daily Mix25 or NPH for 3 months, followed by the alternate treatment for 3 months. Primary outcomes were 7-point self-monitored BG profiles, HbA1c, hypoglycaemic rate, and insulin doses. Two-hour pp BG excursions and absolute BG values 2 hours after breakfast and dinner, before lunch, and at 3 am were found to be significantly lower during Mix25 treatment; the fasting BG level was significantly higher. Mean HbA1c was also significantly lower after Mix25 therapy (8.36{\%} versus 8.59{\%}; P=0.043). Hypoglycaemia and total daily insulin dose were not significantly different between treatments. In conclusion, compared with twice-daily NPH, twice-daily Mix25 at similar doses resulted in lower BG excursions after breakfast and dinner, lower BG concentrations at 4 of 7 points on the BG profile, a lower HbA1c, and no increase in hypoglycaemia. Mix25 may be a desirable alternative to NPH for type 2 diabetic patients using twice-daily insulin therapy.",
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AU - Herz, M.

AU - Roach, Paris

PY - 2004

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N2 - Twice-daily NPH monotherapy is commonly prescribed in type 2 diabetes, but it lacks short-or rapid-acting insulin to address postprandial blood glucose (pp BG). Humalog® Mix25™ (Mix25) provides both intermediate-and rapid-acting insulin and may offer a therapeutic advantage. In an open-label crossover study, 66 patients with type 2 diabetes were randomly assigned to twice-daily Mix25 or NPH for 3 months, followed by the alternate treatment for 3 months. Primary outcomes were 7-point self-monitored BG profiles, HbA1c, hypoglycaemic rate, and insulin doses. Two-hour pp BG excursions and absolute BG values 2 hours after breakfast and dinner, before lunch, and at 3 am were found to be significantly lower during Mix25 treatment; the fasting BG level was significantly higher. Mean HbA1c was also significantly lower after Mix25 therapy (8.36% versus 8.59%; P=0.043). Hypoglycaemia and total daily insulin dose were not significantly different between treatments. In conclusion, compared with twice-daily NPH, twice-daily Mix25 at similar doses resulted in lower BG excursions after breakfast and dinner, lower BG concentrations at 4 of 7 points on the BG profile, a lower HbA1c, and no increase in hypoglycaemia. Mix25 may be a desirable alternative to NPH for type 2 diabetic patients using twice-daily insulin therapy.

AB - Twice-daily NPH monotherapy is commonly prescribed in type 2 diabetes, but it lacks short-or rapid-acting insulin to address postprandial blood glucose (pp BG). Humalog® Mix25™ (Mix25) provides both intermediate-and rapid-acting insulin and may offer a therapeutic advantage. In an open-label crossover study, 66 patients with type 2 diabetes were randomly assigned to twice-daily Mix25 or NPH for 3 months, followed by the alternate treatment for 3 months. Primary outcomes were 7-point self-monitored BG profiles, HbA1c, hypoglycaemic rate, and insulin doses. Two-hour pp BG excursions and absolute BG values 2 hours after breakfast and dinner, before lunch, and at 3 am were found to be significantly lower during Mix25 treatment; the fasting BG level was significantly higher. Mean HbA1c was also significantly lower after Mix25 therapy (8.36% versus 8.59%; P=0.043). Hypoglycaemia and total daily insulin dose were not significantly different between treatments. In conclusion, compared with twice-daily NPH, twice-daily Mix25 at similar doses resulted in lower BG excursions after breakfast and dinner, lower BG concentrations at 4 of 7 points on the BG profile, a lower HbA1c, and no increase in hypoglycaemia. Mix25 may be a desirable alternative to NPH for type 2 diabetic patients using twice-daily insulin therapy.

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