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- Title
Basal-bolus insulin therapy in Type 1 diabetes: comparative study of pre-meal administration of a fixed mixture of insulin lispro (50%) and neutral protamine lispro (50%) with human soluble insulin.
- Authors
Herz, M.; Arora, V.; Sun, B.; Ferguson, S. C.; Bolli, G. B.; Frier, B. M.
- Abstract
Abstract Aims To ascertain whether pre-meal administration of 50% insulin lispro and 50% neutral protamine lispro (NPL), given as a fixed mixture (Humalog® Mix50™, Eli Lilly) (Mix50), provides satisfactory glycaemic control throughout the day compared with pre-meal human soluble (regular) insulin as a basal-bolus regimen in people with Type 1 diabetes. Both regimens included bedtime human isophane (NPH) insulin. Methods This was a multinational, multicentre, randomized, open-label, two-period crossover comparison of two insulin treatments for two 12-week periods in 109 patients with Type 1 diabetes. The protocol provided preliminary evaluations of dose requirements and recommendations for insulin dose adjustment when switching regimens on the basis of blood glucose (BG) values. Eight-point BG profiles, frequency of hypoglycaemia, HbA1c , insulin dose, time of injection, and frequency of snacking were assessed during each treatment. Results Total daily insulin dose was similar for both treatments, but the total pre-meal doses were higher (P < 0.001) and the bedtime dose of isophane was lower (P < 0.001) with Mix50. The pre-meal dose before breakfast and lunch, although statistically different (P = 0.006 and P < 0.001, respectively), was of similar magnitude, but the pre-evening meal dose was higher with Mix50 (P < 0.001). Median (interquartile range) time of insulin injection before meals was: Mix50 4.2 (25th percentile = 1.0; 75th percentile = 6.3) min, human soluble insulin 24.6 (25th percentile = 16.6; 75th percentile = 30.0) min. Pre-meal and bedtime BG concentrations did not differ between treatments. The BG 2 h after the evening meal was lower with Mix50 (8.40 ± 2.95 mmol/l vs. 9.60 ± 3.47 mmol/l) (P = 0.049). BG after breakfast and lunch, mean HbA1c , frequency of hypoglycaemia, frequency of snacks, and body weight were not different. Conclusion The use of Mix50 in a basal-bolus regimen achieved similar control of...
- Subjects
DIABETES; INSULIN; HYPOGLYCEMIA
- Publication
Diabetic Medicine, 2002, Vol 19, Issue 11, p917
- ISSN
0742-3071
- Publication type
Article
- DOI
10.1046/j.1464-5491.2002.00830.x