Two injections of biphasic insulin aspart (70/30, is more effective then glargine.
In patients with type 2 diabetes poorly controlled on oral antidiabetic drugs, the use of biphasic insulin aspart (70/30 BIAsp) appears to be more effective than long-acting insulin glargine in achieving glycemic control.
Dr. Raskin, of the University of Texas, Dallas stated that, "You can do better with two injections of a mix of intermediate and short acting insulin than you can with a single dose of glargine, a long-acting insulin," particularly when baseline HbA1c values are high.
BIAsp 70/30 (NovoLog Mix 70/30, Novo Nordisk) contains 30% soluble insulin aspart and 70% insulin aspart crystallized with protamine, which is used to control both fasting and postprandial hyperglycemia, , and his colleagues point out.
They included in their study patients with HbA1c values of 8% or higher who were being maintained on metformin. A total of 108 subjects were randomly assigned to BIAsp 70/30 before breakfast and dinner, and 114 to glargine at bedtime. Both groups continued treatment with insulin sensitizers. Insulin doses were titrated to achieve target fasting plasma glucose levels.
After 28 weeks, mean HbA1c values were lower in the BIAsp 70/30 group (6.91 versus 7.41). In addition, more BIAsp 70/30-treated subjects achieved HbA1c of less than 7.0% (66% versus 40%).
In those with a baseline HbA1c of > 8.5%, mean reductions were 3.13% in BIAsp patients and 2.60% in glargine patients.
Thus, Dr. Raskin concluded, "the differences were even more remarkable in those that started with higher baseline HbA1c."
The clinical trial was financially supported by Novo Nordisk.
Diabetes Care 2005;28:260-265.
DID YOU KNOW:
Diabetes Heart Risk Higher for Women Than Men: Women with diabetes run a greater risk of dying from heart disease than do men with diabetes. Compared to people without diabetes, the risk of cardiovascular death was 2.48-times higher for diabetic women but only 1.87-times greater for diabetic men. This translates to a greater than 50 percent excess relative risk for diabetic women than for diabetic men.
Presented Friday in Orlando at the Second International Conference on Women, Heart Disease, and Stroke