Abstract

Aim: To compare the impact of premixed human insulin 70/30 and two different premixed insulin analogues (insulin lispro mix 75/25 and 50/50) on glucose variation of the patients with type 2 diabetes (T2D).

Methods: A total of 19 T2D patients who were treated with premixed human insulin 70/30 (PHI70/30) more than 90 days. All patients were divided into two groups receiving either insulin lispro mix 75/25 (LM25) or 50/50 (LM50) for 8 weeks. They were then crossed over to the other arm and continued to receive either LM50 or LM25 for 8 weeks. Continuous glucose monitoring (CGM) was performed on all patients for 72 hours in every stage to examine the differences in variability of interstitial glucose. All patients received questionnaire survey regarding subjective feeling of insulin therapy.

Results: No significant difference was found in HbA1c, mean interstitial glucose (MIG) and mean amplitude of glycemic excursion (MAGE) in whole day among three regimens. However, in the subgroup with baseline MIG≥10.0mmol/L (n=6), MIG in whole day in LM25 regimen was significantly lower than that in PHI70/30 regimen (9.4±1.5 vs. 12.2±2.0mmol/L, P=0.024). The largest amplitude of glycemic excursion (LAGE) and MAGE in LM50 regimen were lower than those in LM25 regimen in the period of 22pm-6am (6.9±3.1 vs. 9.8±2.8mmol/L, P=0.034; 2.2±1.9 vs. 4.0±3.0mmol/L, P=0.043; respectively).

Conclusions: Premixed Insulin analogue may provide better glycemic control compared to human premixed insulin in the patients with higher glucose level. The T2D patients with adequate glycemic control or greater risk of hypoglycemia at night were suitable to LM50.

Key words: Premixed human insulin, premixed insulin lispro 75/25, premixed insulin lispro 50/50, glucose excursion, continuous glucose monitoring