When glycaemic targets can no longer be achieved with basal insulin in type 2 diabetes, can simple intensification with a modern premixed insulin help? Results from a subanalysis of the PRESENT study
2008

Improving Diabetes Control with Premixed Insulin

Sample size: 3762 publication 10 minutes Evidence: moderate

Author Information

Author(s): Hak Chul Jang, Serdar Guler, Marina Shestakova

Primary Institution: Seoul National University Bundang Hospital

Hypothesis

Can simple intensification with a modern premixed insulin help patients with type 2 diabetes who are not achieving glycaemic targets with basal insulin?

Conclusion

Patients with type 2 diabetes who are failing to reach glycaemic targets on basal insulin can achieve better glycaemic control without an increase in overall hypoglycaemia by intensifying with BIAsp 30.

Supporting Evidence

  • HbA1c was significantly lowered in both groups after treatment with BIAsp 30.
  • Reductions in fasting plasma glucose and postprandial plasma glucose were statistically significant.
  • The rate of overall hypoglycaemia remained constant in patients switching from analogue basal insulin but decreased in those switching from human basal insulin.

Takeaway

If someone with diabetes isn't getting better with their current insulin, switching to a new type can help them feel better without causing more low blood sugar.

Methodology

This was a 6-month observational study analyzing data from patients previously treated with basal insulin who switched to BIAsp 30.

Potential Biases

The lack of randomization and reliance on physician discretion for treatment adjustments may introduce bias.

Limitations

The study was observational and relied on patient recollection for hypoglycaemia and adverse drug reactions, which may lead to under-reporting.

Participant Demographics

{"gender":{"male":54.7,"female":45.3},"mean_age":56.9,"mean_diabetes_duration":10.4,"mean_weight":72.7,"mean_BMI":27.2}

Statistical Information

P-Value

p<0.0001

Confidence Interval

95% CI

Statistical Significance

p<0.0001

Digital Object Identifier (DOI)

10.1111/j.1742-1241.2008.01792.x

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