Issue 122 Item 7 Mix25 Insulin Mixture Gives Type 2’s Better Control Than Human

Mix25, a fixed mixture of 25 percent insulin lispro and 75 percent novel intermediate acting insulin, provides better postprandial plasma glucose control than does human insulin 30/70, without increasing the risk of exercised-induced hypoglycemia. >Matthias Herz and colleagues at the Eli Lilly and Company in Indianapolis, Indiana, United States, compared the plasma glucose response effects of Mix 25 and human insulin 30/70 on patients with type 2 diabetes.

The researchers treated 37 patients in a randomized, open-label, eight-week, two-period crossover study. Patients were injected with Mix25 five minutes before breakfast and dinner throughout the study. On inpatient test days and on outpatient dose titration days, they were injected instead with 30/70 human insulin five minutes before breakfast and dinner.

Following the four-week outpatient phase, patients were hospitalized and, three hours after a 339 kcal breakfast, were exercised at a heart rate of 120 beats per minute on a cycle ergometer two times for 30 minutes, separated by a 30 minute rest.

The two-hour postprandial plasma glucose levels of patients were significantly lower with Mix25 than with human insulin 30/70 (mean 10.5 mmol/l vs.11.6 mmol/l), the researchers reported. Maximum decrease in plasma glucose from onset of exercise to end of exercise was significantly less with Mix25 (mean -3.6 mmol/l vs -4.7 mmol/l). And the maximum decrease in plasma glucose levels over six hours after exercise onset was significantly less with Mix25 (-4.3 mmol/l vs -5.9 mmol/l).

"Mix25 resulted in better postprandial plasma glucose control without an increase in exercise-induced hypoglycemia," the researchers reported. "The smaller decrease in plasma glucose during the postprandial phase after exercise may suggest a lower risk of exercise-induced hypoglycemia with Mix25 than with human insulin 30/70, especially for patients in tight glycemic control." Curr Med Res Opin 2002; 18: 188-193