Twice Daily 70/30 Insulin + Metformin Vs. Lantus + Glimepiride in Type 2’s

Which treatment therapy was more effective? Purpose of the study was to compare the efficacy and safety of two analog insulins as starting regimens in insulin-naive Type 2 diabetes patients.: In this randomized, open-label parallel study, twice-daily biphasic insulin aspart 30 (30% soluble and 70% protaminated insulin aspart; BIAsp 30) plus metformin (met) was compared with once-daily insulin glargine (glarg) plus glimepiride (glim) in 255 insulin-naive patients (131 male; mean+/-SD age, 61.2+/-9.1 years).

Mean baseline HbA (1c) (+/-SD) was 9.2+/-1.4% and 8.9+/-1.3% for BIAsp 30 plus met ( N=128) and glarg plus glim ( N=127), respectively ( P=0.0747). Primary endpoint was the difference in absolute change in HbA (1c) between groups after 26 weeks of treatment

The results showed that HbA1c change was significantly greater in the BIAsp 30 plus met group than the glarg plus glim group (between-group difference: -0.5% (95% CI: -0.8; -0.2); P=0.0002). Mean prandial plasma glucose increment was significantly lower for BIAsp 30 plus met compared with glarg plus glim: 1.4+/-1.4 mmol/l vs. 2.2+/-1.8 mmol/l; P=0.0002. During the maintenance phase (weeks 6-26), one major hypoglycemic episode occurred in each group; 20.3% and 9% of patients experienced minor hypoglycemic episodes in the BIAsp 30 plus met and glarg plus glim groups, respectively ( P=0.0124). At end-of-trial, mean daily insulin doses were 0.40 U/kg BIAsp 30 and 0.39 U/kg glarg. Glarg plus glim-treated patients experienced significant weight gain of 1.5 kg (95% CI: 0.84; 2.19; P<0.0001). Weight change with BIAsp 30 plus met of +0.7 kg was not statistically significant (95% CI: -0.07; 1.42; P=0.0762).

From the results it was concluded that starting insulin in Type 2 diabetes patients with twice-daily BIAsp 30 plus met can reduce HbA (1c) and mean prandial plasma glucose increment to a greater extent than once-daily glargine and glimepiride.

Exp Clin Endocrinol Diabetes. 2006 Oct;114(9):527-32.

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Proc Natl Acad Sci 2006;103:17438-17443.

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Cure for Diabetes: For all those out there suffering from type 1 diabetes, there may now be hope for a cure. Type 1 diabetes occurs when the body’s own immune system destroys the insulin-producing cells of the pancreas. An article in the Nov. 24 issue of Science Magazine talks about the most recent findings of research tests done on mice. In these experiments, the mice were given injections and infusions of insulin and spleen cells. The experiment resulted in the cure of 32 percent of the mice of their established diabetes.

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