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Kann, PH; Wascher, T; Zackova, V; Moeller, J; Medding, J; Szocs, A; Mokan, M; Mrevlje, F; Regulski, M.
Starting insulin therapy in type 2 diabetes: twice-daily biphasic insulin Aspart 30 plus metformin versus once-daily insulin glargine plus glimepiride.
Exp Clin Endocrinol Diabetes. 2006; 114(9):527-532 Doi: 10.1055/s-2006-949655
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Co-authors Med Uni Graz: Wascher Thomas
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Abstract:: AIM: To compare the efficacy and safety of two analog insulins as starting regimens in insulin-naïve Type 2 diabetes patients. METHODS: 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-naïve 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. RESULTS: HbA (1c) 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). CONCLUSIONS: 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 glarg plus glim.
Find related publications in this database (using NLM MeSH Indexing): Aged -; Blood Glucose - analysis; Body Weight - drug effects; Diabetes Mellitus, Type 2 - drug therapy; Dose-Response Relationship, Drug - drug therapy; Drug Administration Schedule - drug therapy; Drug Therapy, Combination - drug therapy; Female - drug therapy; Hemoglobin A, Glycosylated - analysis; Humans - analysis; Hypoglycemia - epidemiology; Hypoglycemic Agents - administration and dosage; Insulin - administration and dosage; Male - administration and dosage; Metformin - administration and dosage; Middle Aged - administration and dosage; Sulfonylurea Compounds - administration and dosage; Treatment Outcome - administration and dosage
Find related publications in this database (Keywords): insulin initiation; biphasic insulin aspart 30 plus metformin; insulin glargine plus glimepiride; type 2 diabetes mellitus; premixed insulin analog