TY - JOUR
T1 - Basal insulin or premix analogue therapy in type 2 diabetes patients
AU - Raskin, Philip
AU - Hollander, Priscilla A.
AU - Lewin, Andrew
AU - Gabbay, Robert A.
AU - Bode, Bruce
AU - Garber, Alan J.
N1 - Copyright:
Copyright 2009 Elsevier B.V., All rights reserved.
PY - 2007/1
Y1 - 2007/1
N2 - Background: We sought to compare the safety and efficacy of biphasic insulin aspart 30 (BIAsp 30) given twice daily with once-daily insulin glargine in patients with type 2 diabetes beginning insulin therapy and who did not use thiazolidinediones, which are contraindicated with insulin in the European Union, in a subpopulation (N = 157) of the INITIATE study. Methods: At baseline, HbA1c was ≥ 8.0% on ≥ 1000 mg/day metformin alone or in combination with other oral antidiabetic drugs (OADs; e.g. sulphonylurea or alpha-glucosidase inhibitors). Metformin was adjusted up to 2550 mg/day and other OADs were discontinued. Starting insulin doses were subsequently adjusted weekly for 26 weeks by algorithm-directed titration. Results: The proportion of patients achieving a HbA1c below 7.0% at 28 weeks was greater with BIAsp 30 than with insulin glargine (65% vs 41%, P = 0.003). The mean reduction in HbA1c was greater for BIAsp 30 than for insulin glargine: - 2.89 ± 1.6% vs - 2.46 ± 1.6%, respectively (P = 0.035). Postprandial glucose increments were lower for the BIAsp 30 group after breakfast (P = 0.003) and dinner (P = 0.033); post-lunch values were not significantly different. No major hypoglycemic episodes were recorded. Nocturnal hypoglycemia was reported by 25% of subjects in the BIAsp 30 group and by 10% in the insulin glargine group (P = 0.021). Weight gain was 5.6 ± 4.6 and 3.0 ± 4.3 kg (P = 0.0004) for BIAsp 30 and insulin glargine, respectively. Conclusions: BIAsp 30, given twice daily in combination with metformin, was more effective than insulin glargine, given once daily in combination with metformin, at controlling blood glucose in insulin-naïve patients with type 2 diabetes, but was associated with increased weight gain and minor hypoglycemic events.
AB - Background: We sought to compare the safety and efficacy of biphasic insulin aspart 30 (BIAsp 30) given twice daily with once-daily insulin glargine in patients with type 2 diabetes beginning insulin therapy and who did not use thiazolidinediones, which are contraindicated with insulin in the European Union, in a subpopulation (N = 157) of the INITIATE study. Methods: At baseline, HbA1c was ≥ 8.0% on ≥ 1000 mg/day metformin alone or in combination with other oral antidiabetic drugs (OADs; e.g. sulphonylurea or alpha-glucosidase inhibitors). Metformin was adjusted up to 2550 mg/day and other OADs were discontinued. Starting insulin doses were subsequently adjusted weekly for 26 weeks by algorithm-directed titration. Results: The proportion of patients achieving a HbA1c below 7.0% at 28 weeks was greater with BIAsp 30 than with insulin glargine (65% vs 41%, P = 0.003). The mean reduction in HbA1c was greater for BIAsp 30 than for insulin glargine: - 2.89 ± 1.6% vs - 2.46 ± 1.6%, respectively (P = 0.035). Postprandial glucose increments were lower for the BIAsp 30 group after breakfast (P = 0.003) and dinner (P = 0.033); post-lunch values were not significantly different. No major hypoglycemic episodes were recorded. Nocturnal hypoglycemia was reported by 25% of subjects in the BIAsp 30 group and by 10% in the insulin glargine group (P = 0.021). Weight gain was 5.6 ± 4.6 and 3.0 ± 4.3 kg (P = 0.0004) for BIAsp 30 and insulin glargine, respectively. Conclusions: BIAsp 30, given twice daily in combination with metformin, was more effective than insulin glargine, given once daily in combination with metformin, at controlling blood glucose in insulin-naïve patients with type 2 diabetes, but was associated with increased weight gain and minor hypoglycemic events.
KW - Clinical protocols
KW - Hypoglycemic agents
KW - Insulin analogs
KW - Type 2 diabetes mellitus
UR - http://www.scopus.com/inward/record.url?scp=33846254561&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33846254561&partnerID=8YFLogxK
U2 - 10.1016/j.ejim.2006.09.006
DO - 10.1016/j.ejim.2006.09.006
M3 - Article
C2 - 17223044
AN - SCOPUS:33846254561
SN - 0953-6205
VL - 18
SP - 56
EP - 62
JO - European Journal of Internal Medicine
JF - European Journal of Internal Medicine
IS - 1
ER -