This article originally posted 30 September, 2008 and appeared in Issue 436
Pre-Mixed More Effective Then Long-Acting Insulin For Controlling Post-Meal Blood Glucose Levels
Pre-mixed insulin analogues, a modified form of conventional pre-mixed human insulin, are more effective than long-acting analogues for controlling high blood sugar levels after meals in patients with type 2 diabetes, according to a new report.
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Conventional pre-mixed human insulin, however, appears to be equally effective as pre-mixed insulin analogues for lowering blood sugar levels when patients go eight or more hours without eating, according to the report.
The report represents a systematic review of 45 research studies.
“While it is clear that pre-mixed insulin analogues offer certain advantages to patients with diabetes, what is good for one patient may not be good for another,” said AHRQ Director Carolyn M. Clancy, M.D. “This report offers an important reminder that patients with diabetes should review their treatment plans carefully with their physician.”
Pre-mixed insulin analogues are a modified form of conventional pre-mixed human insulin. AHRQ’s report compared pre-mixed insulin analogues with conventional pre-mixed human insulin, oral diabetes drugs, and two other kinds of insulin analogues – long-acting (or “basal”) analogues, and rapid-acting (or “bolus”) analogues.
Additional findings in AHRQ’s new report:
• Long-acting insulin analogues appear to be more effective than pre-mixed insulin analogues in lowering fasting blood sugar levels.
• Pre-mixed insulin analogues are better than long-acting analogues alone in lowering blood sugar levels after a meal with high sugar content.
• Pre-mixed insulin analogues are more effective than long-acting analogues in lowering Hemoglobin A1c, which is a highly reliable indicator of chronic high blood sugar.
• Pre-mixed insulin analogues are more effective than non-insulin antidiabetic medications in lowering fasting blood sugar levels.
• Pre-mixed insulin analogues are more likely than long-acting analogues to be associated with hypoglycemia (blood sugar so low that it can cause symptoms such as fainting), and are similar to pre-mixed human insulin preparations in terms of the frequency of hypoglycemia reported.
• Pre-mixed insulin analogues are associated with a higher frequency of hypoglycemic events than oral antidiabetic (non-insulin) agents are.
The report, Comparative Effectiveness, Safety and Indications of Pre-mixed Insulin Analogues for Adults With Type 2 Diabetes, is available at http://effectivehealthcare.ahrq.gov.
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DID YOU KNOW:
Long-term benefit of blood-sugar control: Diabetics who tightly control their blood sugar -- even if only for the first decade after they are diagnosed -- have lower risks of heart attack, death and other complications 10 or more years later, a large follow-up study has found. The discovery of this legacy effect" may put new emphasis on rigorous treatment when people first learn they have Type 2 diabetes, the most common form and the type linked to obesity. Doctors warn that people should not let their blood sugar spin out of control -- that could have serious health consequences. Results were published online by the New England Journal of Medicine, Sept 2008
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