|
Intensifying existing premix therapy (BIAsp 30) with BIAsp 50 and BIAsp 70: A consensus statement
Miguel Brito1, Robert Jan Ligthelm2, Massimo Boemi3, Ajay Kumar4, Itamar Raz5, Teresa Koblik6, Yan Gao7, Jens Sandahl Christiansen8
1 Department of Endocrinology and Nutrition, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
2 Internist, Tropvacc B.V., Rotterdam, The Netherlands
3 Department of Specialist Medicine, UOC Diabetologia - INRCA-IRCCS, Ancona, Italy
4 Diabetes Care and Research Centre, Patna, India
5 Diabetes Unit, Hadassah Ein Kerem Hospital, Jerusalem, Israel
6 Cathedral and Clinic of Metabolic Diseases, Jagiellonian University, Kraków, Poland
7 Department of Endocrinology, Peking University First Hospital, Beijing, China
8 Department of Endocrinology and Diabetes, Aarhus University Hospital, Aarhus, Denmark
Correspondence Address:
Miguel Brito
Department of Endocrinology and Nutrition, Hospital Universitario Puerta de Hierro Majadahonda, C/Manuel de Falla, 1, Majadahonda 28220, Madrid
Spain
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/2230-8210.83396
|
|
In 2009, consensus guidelines were published on intensification of insulin therapy using the premix analog biphasic insulin aspart (BIAsp) 30 in the treatment of type 2 diabetes, based on the recommendations of an international, independent expert panel. The guidelines included recommendations and titration algorithms for intensification from basal insulin once (OD) or twice daily (BID) to BIAsp 30 BID, from OD BIAsp 30 to BID, and from BID BIAsp 30 to three times daily (TID). Building on these recommendations, the objective was to develop similar, simple and effective guidelines for intensification switch from a BIAsp 30 to a mid-/high-ratio premix regimen for the vast majority of patients with type 2 diabetes. A panel of independent experts with extensive clinical experience in premix analog therapy met in October 2009 to review the therapeutic role of mid- and high-ratio premixes (BIAsp 50 and 70, respectively). The panel outlined a series of algorithms for intensifying BIAsp 30 BID and TID with mid-/high-ratio premixes, along with practical suggestions relating to intensification for individual patients. A simple tool to aid dose adjustment was also developed. The guidelines suggested here should assist physicians in introducing mid-/high-ratio premixes to optimize the insulin therapy of patients with type 2 diabetes who are failing to achieve glycemic targets on a BIAsp 30 BID or TID regimen. |
