The benefits of the therapy were particularly significant in patients with baseline levels higher than 8.5%. Patients with type 2 diabetes who are new to insulin therapy are more likely to reach their target HbA1c level when treated with biphasic insulin aspart 70/30 than with insulin glargine, according to a new study led by Philip Raskin, MD, from the University of Texas Southwestern Medical Center in Dallas.
Based on results from the INITIATE study and published in Diabetes Care, this research compared the effects of biphasic insulin aspart 70/30 (NovoLog Mix 70/30, Novo Nordisk) to insulin glargine in patients with type 2 diabetes.
According to Raskin, 66% of patients treated with biphasic insulin aspart 70/30 reached their target HbA1c level of 7%, compared to 40% of patients in the insulin glargine group. The benefits of biphasic insulin aspart 70/30 were particularly significant in patients with baseline HbA1c levels higher than 8.5%.
A total of 233 patients with type 2 diabetes were studied. At baseline, all patients were insulin-naive and had an HbA1c level of 8% or higher. All were taking metformin 1,000 mg per day alone or in combination with other oral antidiabetic agents.
Metformin was adjusted to 2,550 mg per day before insulin therapy began. Patients were then randomized to receive biphasic insulin aspart 70/30 or insulin glargine for the duration of the 28-week study.
A total of 209 patients completed the study. The mean HbA1c value was 6.91% in the biphasic insulin aspart 70/30 group and 7.41% in the insulin glargine group.
The average reduction in HbA1c was 2.79% in the biphasic insulin aspart 70/30 group and 2.36% in the insulin glargine group. Among patients with a baseline HbA1c higher than 8.5%, the average reduction was 3.13% in the biphasic insulin aspart 70/30 group and 2.60% in the insulin glargine group.
Raskin said this study demonstrates that biphasic insulin aspart 70/30 is a viable option for patients with poorly-controlled HbA1c. “With [biphasic insulin aspart 70/30], doctors have another option for treating patients who may not be responding well to other therapies.”
Diabetes Care. 2005;28:260-265. Raskin P, Allen E, Hollander P, et al. Initiating insulin therapy in type 2 diabetes: A comparison of biphasic and basal insulin analogs.