Effects of Twice-Daily Injections of Premixed Insulin Analog on Glycemic Control in Type 2 Diabetic Patients
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Purpose: Premixed insulin is effective to improve glycemic control; however,clinicians may be less likely to know which premixed insulin is appropriate for which patients. This study aimed to evaluate the effects of twice-daily injections of premixed insulin lispro on glycemic control in type 2 diabetic patients. Materials and Methods: Forty type 2 diabetic patients, who had been treated with twicedaily injections of human protamine mixture 30/70 insulin for at least 12 months,were divided into two groups; one group whose blood glucose 2 hours after breakfast was greater than 200 mg/dL, was switched to lispro mix50, and the other group whose blood glucose 2 hours after breakfast < 200 was switched to lispro mix25. Results: Glycated haemoglobin (HbA1c) significantly improved in the Mix50 group from 8.3% to 7.5% (at 12 weeks; p < 0.05), and to 7.5% (at 24weeks; p < 0.05). On the other hand, HbA1c levels in the Mix25 group were slightly decreased from 8.1% to 7.7% at 12 weeks (p < 0.05), and to 7.9% at 24weeks (not significant). Both postprandial plasma glucose and fasting plasma glucose levels were significantly improved in the Mix50 group, but not in the Mix25 group. Overall, 95% of subjects preferred premixed lispro insulin from human insulin in the viewpoint of the timing of insulin injection by questionnaire analysis. Conclusion: Switching from human protamine mixture 30/70 insulin to lispro mix50 twice-daily injection therapy in patients with high postprandial plasma glucose could improve their glycemic control and quality of life.
Abstract
Purpose: Premixed insulin is effective to improve glycemic control; however,clinicians may be less likely to know which premixed insulin is appropriate for which patients. This study aimed to evaluate the effects of twice-daily injections of premixed insulin lispro on glycemic control in type 2 diabetic patients. Materials and Methods: Forty type 2 diabetic patients, who had been treated with twicedaily injections of human protamine mixture 30/70 insulin for at least 12 months,were divided into two groups; one group whose blood glucose 2 hours after breakfast was greater than 200 mg/dL, was switched to lispro mix50, and the other group whose blood glucose 2 hours after breakfast < 200 was switched to lispro mix25. Results: Glycated haemoglobin (HbA1c) significantly improved in the Mix50 group from 8.3% to 7.5% (at 12 weeks; p < 0.05), and to 7.5% (at 24weeks; p < 0.05). On the other hand, HbA1c levels in the Mix25 group were slightly decreased from 8.1% to 7.7% at 12 weeks (p < 0.05), and to 7.9% at 24weeks (not significant). Both postprandial plasma glucose and fasting plasma glucose levels were significantly improved in the Mix50 group, but not in the Mix25 group. Overall, 95% of subjects preferred premixed lispro insulin from human insulin in the viewpoint of the timing of insulin injection by questionnaire analysis. Conclusion: Switching from human protamine mixture 30/70 insulin to lispro mix50 twice-daily injection therapy in patients with high postprandial plasma glucose could improve their glycemic control and quality of life.
참고문헌 (14)
- Ohkubo Y, "Intensive insulin therapy prevents the progression of diabetic microvascular complications in Japanese patients with non-insulin-dependent diabetes mellitus: a randomized prospective 6-year study", Diabetes Res Clin Pract, 28, pp.103~117 (1995)
- Masuda H, "Comparison of twice-daily injections of biphasic insulin lispro and basal-bolus therapy: glycemic control and quality-of-life of insulin-naïve type 2 diabetic patients", Diabetes Obes Metab, 10, pp.1261~1265 (2008)
- UK Prospective Diabetes Study (UKPDS) Group, "Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33)", Lancet, 352, pp.837~853 (1998)
- Roach P, "Improved postprandial blood glucose control and reduced nocturnal hypoglycemia during treatment with two novel insulin lisproprotamine formulations, insulin lispro mix25 and insulin lispro mix50. Mix50 Study Group", Clin Ther, 21, pp.523~534 (1999)
- Schwartz S, "A single-center, randomized, double-blind, three-way crossover study examining postchallenge glucose responses to human insulin 70", 30 and insulin lispro fixed mixtures 75, 50 in patients with type 2 diabetes mellitus, pp.Clin Ther, 2006[DOI]
- Mattoo V, "A comparison of insulin lispro Mix25 and human insulin 30", 70 in the treatment of type 2 diabetes during Ramadan, 2003, pp.59, 137~143
- Coscelli C, "Importance of premeal injection time in insulin therapy: Humalog Mix25 is convenient for improved postprandial glycemic control in type 2 diabetic patients with Italian dietary habits", Acta Diabetol, 40, pp.187~192 (2003)
- Malone JK, "Twice-daily pre-mixed insulin rather than basal insulin therapy alone results in better overall glycemic control in patients with Type 2 diabetes", Diabet Med, 22, pp.374~381 (2005)
- Shichiri M, "Long-term results of the Kumamoto Study on optimal diabetes control in type 2 diabetic patients", Diabetes Care, 23, pp.B21~29 (2000)
- Yamada S, "Switching from premixed human insulin to premixed insulin lispro: a prospective study comparing the effects on glucose control and quality of life", Intern Med, 46, pp.1513~1517 (2007)
- Roach P, "Humalog Mix50 before carbohydrate-rich meals in type 2 diabetes mellitus", Diabetes Obes Metab, 5, pp.311~316 (2003)
- Schernthaner G, "Metabolic control in patients with type 2 diabetes using Humalog Mix50 injected three times daily: crossover comparison with human insulin 30", 70, 2004, pp.36, 188~193
- Koivisto VA, "Lispro Mix25 insulin as premeal therapy in type 2 diabetic patients", Diabetes Care, 22, pp.459~462 (1999)
- Mudalair SRD, "Intensive insulin therapy for patients with type 2 diabetes mellitus. In Diabetes Mellitus: a Fundamental and Clinical Text.", pp.20~38 (2000), Lippincott Williams & Wilkins