Introduction Of Biphasic Insulin Therapy For The Poorly Controlled Type 2 Diabetics Can Help In Achieving Recommended Glycemic Targets


Abstract:Introduction: Insulin therapy in type 2 diabetes is either delayed or is suboptimal. Achieving intensive glycemic control will have the greatest benefits in patients with less advanced disease. OBJECTIVES: To demonstrate that introduction of biphasic insulin therapy can help in achieving stringent recommended glycemic control in poorly controlled diabetics. Methods: Six months prospective study on introduction of biphasic insulin instead of variable treatment modalities was carried out on 71 poorly controlled type 2 diabetics. Patients were interviewed three times, at the begining, after three and six months each time they were examined physically and investigated thoroughly. Results: Glycemic control parameters, glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG) and postprandial plasma glucose (PPG) were investigated at the baseline , after three and six months. The parameters had shown a statistical significant reduction to meet the recommended glycemic control targets of the American Diabetes Association (ADA) and very close to the International Diabetes Federation, European Diabetes Policy Group (IDF). Lipid profiles were investigated at the beginning and after three months of the study. Total cholesterol, LDL-C and non-HDL-C were achieved statistical significant reduction. The triglyceride, VLDL-C, HDL-C and atherogenic index (TC/ HDL-C ratio) were reduced but the achievements were statistically insignificant. Conclusion: Biphasic insulin aspart progressively enable the poorly controlled type 2 diabetics to achieve the recommended glycemic targets. Achievements of the recommended targets reduce and/or normalize the lipid profile elements. Excellent results obtained can break down the patients and physicians barriers against use of insulin in type2 diabetes.Key Words: type 2 diabetes mellitus, biphasic insulin, glycemic control, lipid profile