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- Title
The optimal morning:evening ratio in total dose of twice-daily biphasic insulin analogue in poorly controlled Type 2 diabetes: a 24-week multi-centre prospective, randomized controlled, open-labelled clinical study.
- Authors
Jung, C. H.; Park, J.‐Y.; Cho, J. H.; Yoon, K.‐H.; Yang, H. K.; Lee, Y.‐H.; Cha, B. S.; Lee, B.‐W.
- Abstract
Aims Biphasic insulin analogues are widely used in patients with Type 2 diabetes mellitus suboptimally controlled on oral anti-diabetic drugs. Several topics in this area remain controversial, including how to divide the daily dose of biphasic insulin analogue. We aimed to determine the optimal dosing ratio of twice-daily biphasic insulin analogue and to compare the glycaemic efficacy among groups of patients using different initial dosing ratios of biphasic insulin analogue. Methods A total of 100 poorly controlled insulin-naive subjects with Type 2 diabetes [HbA1c ≥ 58 mmol/mol, (7.5%)] on oral anti-diabetic drugs were randomized into three groups according to initial morning:evening dosing ratio (group I, 50:50; group II, 55:45; group III, 60:40) of twice-daily biphasic insulin analogue (biphasic insulin aspart 70/30, biphasic insulin aspart 30). The primary outcome measure was the difference in pre-breakfast to pre-dinner dose ratio at the end of the study. Results Twice-daily biphasic insulin analogue showed a significant improvement in glycaemic control [HbA1c from 70 mmol/mol (8.6%) to 60 mmol/mol (7.6%)] after 24 weeks regardless of the initial dose ratio given. Despite the similar efficacy and safety profiles among three groups, morning dose was significantly increased (from 50:50 to 55:45-60:40) in group I after 24 weeks. However, there was no significant change in splitting ratio in groups II and III (with higher morning dose) over the 24-week treatment period. Conclusions These results indicate that initiating twice-daily biphasic insulin analogue on regimens with a higher dose before breakfast than before dinner (i.e. ratio approximately 55:45 to 60:40) might be more appropriate in Korean subjects with Type 2 diabetes.
- Subjects
TYPE 2 diabetes treatment; HYPOGLYCEMIC agents; BLOOD sugar monitoring; CLINICAL trials; DIABETES; GLYCOSYLATED hemoglobin; INJECTIONS; INSULIN; METABOLIC regulation; TYPE 2 diabetes; SAFETY; DISEASE management; DATA analysis; BODY mass index; TREATMENT duration
- Publication
Diabetic Medicine, 2014, Vol 31, Issue 1, p68
- ISSN
0742-3071
- Publication type
Article
- DOI
10.1111/dme.12322