Novel Insulin & Better Glycemic Control in Type 2 Diabetics

Abstract

Background: Recently a new premixed insulin analogue has been introduced with good results achieved in different parts of the world particularly regarding good glycemic control and safety.Objective: This clinical study was conducted to evaluate the effectiveness and safety of introducing new insulin (biphasic insulin aspart 70/30)for the treatment of type 2 diabetic patients.Methods: This prospective follow up study included 68 type 2 diabetic patients who has been randomly selected from those attending the National Diabetes Centre (NDC)of Almustansiria University during the period between 1st of oct.2004 to 31st of march 2005.Each patient had been followed for an average period of 6 months. Detailed history had been recorded and thorough physical examination has been performed for each patient. Readings of fasting and postprandial plasma glucose (FPG,PPPG), HbA1c,body mass index (BMI), and the frequency of hypoglycemic attacks had been recorded at the baseline ,interim, and the final visit which had been separated by 3 months between each other. At the baseline visit , each patient has been instructed how to use insulin pen properly and biphasic insulin aspart 70/30 had been supplied to the patients included in this study freely. Statistical analysis using students t-test had been used to assess the difference between different means using a p value of less than 0.05 as the level of statistical significance.Results: This study showed that there was significant difference between the mean human insulin dose used before the study(48.3u/day) and the mean premixed insulin Aspart(36.88u/day) P value less than 0.05.The use of insulin analogue was associated with significant reduction in FPG (130.5mg/Dl in the last visit ,compared with 216mg/Dl in the 1st visit )P value less than 0.001,and the PPPG (160.2mg/Dl compared with 280mg/Dl in the 1st and last visit respectively)P value less than 0.001, and the mean HbA1c (7.1% compared with 9.41%)P value less than 0.001.There was no significant difference between the 1st and last visit recordings of BMI (27.9Kg/m2 compared with 28.1Kg/m2 respectively )P value more than 0.05 ,and in the average incidence of mild hypoglycemic episodes (1.01 compared with 0.42 episode respectively)P value more than 0.05.Conclusion: This study showed that the use of this type of insulin analogue for type2DM lead to marked and statistically significant improvement in the glycemic control ,mainly in the PPPG. In addition the use of this type of insulin was associated with only mild elevation in the BMI and slight lowering in the incidence of hypoglycemic episodes ,both non-significant statistically.