Can simple intensification of therapy with modern two-phase insulin help in type 2 diabetes when target glycemia failed to be achieved withbasal insulin? Results of subanalysis in the PRESENT study
https://doi.org/10.14341/2072-0351-5459
Abstract
Aim.
To evaluate efficiency and safety of intensification of therapy by substituting two-phase insulin aspart 30 (DiAsp 30) for basal insulin in patients with type2 diabetes mellitus after a failure to achieve target glycemia.
Materials and methods.
Analysis of the data obtained in a group of patients involved in the PRESENT study (Physicians Routine Evaluation of Safety andEfficacy of NovoMix 30 Therapy), a 6 month-long observational study conducted in 15 countries. The subanalysis included patients previously treated with along-acting insulin analog (AB, n=34) or intermediate and long-acting human basal insulin (HB, n=3414) and transferred thereafter to DiAsp 30 therapy.End-points of efficiency were the difference between blood HbА1c and glucose (fasting and postprandial) levels measured at the onset of the study and upon itscompletion, the number of hypoglycemic episodes and adverse events, physician and patients content with the results of the treatment. End-points were consideredseparately with reference to preceding basal therapy (AB or HB).
Results.
Treatment with DiAsp 30 for 6 months resulted in a fall of HbА1c levels compared with initial values (-1,60 and -142% in AB and HB patients respectively,p<0,0001). Fasting and postprandial glucose levels also significantly decreased. The frequency of hypoglycemic episodes (number of events/patients/years) after transfer from AB therapy to DiAsp 30 remained virtually unaltered but decreased (-3,8, p<0,001) in the patients previously treated with HB.
Conclusion.
In routine clinical practice, patients with DM2 who failed to have target glycemia after treatment with basal insulin may benefit from transfer toDiAsp 30 without a rise in the frequency of hypoglycemia.
To evaluate efficiency and safety of intensification of therapy by substituting two-phase insulin aspart 30 (DiAsp 30) for basal insulin in patients with type2 diabetes mellitus after a failure to achieve target glycemia.
Materials and methods.
Analysis of the data obtained in a group of patients involved in the PRESENT study (Physicians Routine Evaluation of Safety andEfficacy of NovoMix 30 Therapy), a 6 month-long observational study conducted in 15 countries. The subanalysis included patients previously treated with along-acting insulin analog (AB, n=34) or intermediate and long-acting human basal insulin (HB, n=3414) and transferred thereafter to DiAsp 30 therapy.End-points of efficiency were the difference between blood HbА1c and glucose (fasting and postprandial) levels measured at the onset of the study and upon itscompletion, the number of hypoglycemic episodes and adverse events, physician and patients content with the results of the treatment. End-points were consideredseparately with reference to preceding basal therapy (AB or HB).
Results.
Treatment with DiAsp 30 for 6 months resulted in a fall of HbА1c levels compared with initial values (-1,60 and -142% in AB and HB patients respectively,p<0,0001). Fasting and postprandial glucose levels also significantly decreased. The frequency of hypoglycemic episodes (number of events/patients/years) after transfer from AB therapy to DiAsp 30 remained virtually unaltered but decreased (-3,8, p<0,001) in the patients previously treated with HB.
Conclusion.
In routine clinical practice, patients with DM2 who failed to have target glycemia after treatment with basal insulin may benefit from transfer toDiAsp 30 without a rise in the frequency of hypoglycemia.
About the Authors
Ch S Yang
Bundang National University Hospital and University Medical College, Seul
S Guler
Numune Educational and Research Hospital, Ankara
Marina Vladimirovna Shestakova
Endocrinological Research Centre, Moscow
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Review
For citations:
Yang Ch.S., Guler S., Shestakova M.V. Can simple intensification of therapy with modern two-phase insulin help in type 2 diabetes when target glycemia failed to be achieved withbasal insulin? Results of subanalysis in the PRESENT study. Diabetes mellitus. 2009;12(3):79-84. (In Russ.) https://doi.org/10.14341/2072-0351-5459
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