Injectable biphasic insulin aspart (Novolog Mix 70/30) more effectively enables diabetics to achieve blood glucose level control than does insulin glargine in 177 patients. Lead researcher Philip Raskin, MD, Professor of Medicine, Department of Internal Medicine, University of Texas Southwestern Medical Center in Dallas, Texas, stated that,
"This study indicates that using bi-aspart 70/30 insulin is more efficacious in terms of starting treatment for new patients with type-2 diabetes, as it relates to achieving glycemic goals and as compared to treatment with glargine insulin."
To date, the investigators have enrolled 233 subjects in this 28-week, open-label, parallel-group study, with 177 finishing so far. They included insulin-naive patients with hemoglobin A1c (HbA1c) values >/=8.0%, who were treated with metformin at doses of 1000 mg/day or greater, alone or in combination with other oral antidiabetic agents.
"At baseline, patient characteristics, prior oral antidiabetic drug (OAD) treatment, demographics, and A1c values were similar between treatment groups," the authors reported.
During a 4-week run-in phase, the researchers adjusted the patients’ metformin dosing upward to =1500 mg/day. They also initiated insulin treatment with 6 units of aspart 70/30 twice daily or 10 units of glargine at bedtime. The researchers titrated to target blood glucose (80 to 110 mg/dL), weekly for the first 12 weeks, then at 2-week intervals. The biphasic insulin aspart dose at supper and the bedtime glargine dose were titrated based on fasting blood glucose readings over the previous 3 days. Morning aspart was titrated based on pre-dinner blood glucose readings for the previous 3 days.
At end point, mean HbA1c value in the biphasic insulin aspart cohort was lower than in the insulin glargine cohort. At 28 weeks, 71% of the completers using biphasic insulin aspart had reached the target HbA1c level of 7.0 %, as compared to 45% of the insulin glargine subjects.
The most common adverse event was minor hypoglycemia. No major events were reported among the aspart subjects, and one was reported among the glargine subjects.
"So, for the clinician, bi-aspart is a reasonable choice of insulin when you have someone using tablets who is not responding and you are thinking of initiating another therapy," Dr. Raskin said. "We found in this research that by using bi-aspart 70/30, you can end up with better glycemic controls, better blood sugar levels and a better chance of reaching the goal range than if you use glargine."
Presented study findings at the American Diabetes Association Annual Meeting [Presentation title: " Comparison of Twice-Daily Biphasic Insulin Aspart 70/30 (BIAsp 70/30) with Once-Daily Insulin Glargine (GLA) in Patients with Type 2 DM on Oral Antidiabetic Agents." Abstract #602-P.
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