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Year : 2006  |  Volume : 8  |  Issue : 1  |  Page : 14-19

Twice Daily 30/70 Premixed Insulin (30/70) as Starter Insulin in Asian Patients With Type 2 Diabetes Failing Oral Antidiabetic Medication



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Vinod Mattoo


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Background : Patients with type 2 diabetes (T2DM) failing oral antihyperglycemic medication (OAM) are generally started on a single dose of intermediate acting insulin. We hypothesized that by targeting both fasting (F) and postprandial (PP) glucose levels, twice daily premixed insulin 30/70 [Humulin (30% regular human insulin, 70% NPH) insulin)] can be used as an insulin of initial choice in T2DM patients not adequately controlled by OAM alone. Patients And Methods : In This Multicountry, multicenter, single arm, observational study, data from patients not adequately controlled on OAM was collected for two months after starting 30/70 in an observational setting. Fasting (F) and postprandial (PP) blood glucose values were recorded at baseline (visit 1) at four weeks (visit 2) and at end of the study at eight week (visit 3). Information on insulin dose and adverse events were collected at each visit. A treatment preference questionnaire was administered at the end of the study. Results : This observational study on 1922 patients was conducted across centers in India, Nepal and Indonesia. Treatment with Humulin 30/70 resulted in significant improvement of F blood glucose (131+37 mg/dL at visit 3 Vs 221+66 mg/dL at baseline, p<0.0001) as well as PP blood glucose (185+50 mg/dL at visit 3 Vs 321+81 mg/dL at baseline, p<0.0001). The average daily dose of insulin at the end of the study was 31.6 units compared to 27.9 at the beginning of the study. Body mass index (BMI) was 24.7+3.9 kg/m2 at visit 3 Vs 24.6+4.1 at baseline (P< 0.0001), but with out evident clinical consequences. One patient developed severe hypoglycemia. Most patients (93.9%) felt better using Humulin 30/70 over their previous OAM. Conclusion : Although barriers exist to the early use of insulin therapy in Asian patients with T2DM, this observational study demonstrated improved glycemic control as well as high patient acceptance of 30/70 as the starter insulin therapy after inadequate control with OAM.


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