title: Importance of premeal injection time in insulin therapy: Humalog Mix25 is convenient for improved post-prandial glycemic control in type 2 diabetic patients with Italian dietary habits.
abstract: We investigated the use, in a short period, of Humalog Mix25 (Mix25) in a twice-daily administration regimen compared to a twice-daily injection therapy with Humulin 30/70 (30/70) in diabetic patients with Italian dietary habits. We studied 33 type 2 diabetic patients aged 59.1 +/- 8.1 years, BMI 29.8 +/- 2.7 kg/m2, duration of diabetes and insulin therapy of 14.4 +/- 9.8 and 4.2 +/- 4.6 years, respectively. After a 4-day lead-in period of twice-daily human insulin 30/70 treatment, patients were randomized to one of two treatment sequences: (1) a twice-daily regimen with Mix25 just 5 minutes before the morning and evening meals for 12 days, followed by a twice-daily therapy with human insulin 30/70 given 30 minutes before the morning and evening meals for an additional 12 days; or (2) the alternate sequence. Each patient underwent a mixed meal test: Humulin 30/70 was administered 30 minutes before the meal, while Mix25 was given 5 minutes before. The 2-hour post-prandial glucose concentration after breakfast was significantly lower during treatment with Mix25 than with Humulin 30/70 (157 +/- 43.2 vs. 180 +/- 43.2 mg/dl, p<0.05). The glycemic excursion after dinner on Mix25 treatment was significantly lower than with Humulin 30/70 (12.2 +/- 48.01 vs. 35.5 +/- 36.92 mg/dl, p<0.05). AUCglucose after Mix25 was lower than after Humulin 30/70. Glycemia after test meal was significantly lower with Mix25 than with Humulin 30/70. Insulin and free insulin concentrations after the test meal were significantly higher with Mix25 in comparison to Humulin 30/70. AUC serum insulin and free insulin curves after Mix25 were significantly higher than after Humulin 30/70 (p=0.028 and p=0.005, respectively). Twice-daily injections of Humalog Mix25, compared to human insulin 30/70 in type 2 diabetic patients with Italian dietary habits, provide improved and lasting post-prandial glycemic control, with the great convenience of the injection just before the meal.
authors.affiliation: Department of Internal Medicine and Metabolic Diseases, Parma Hospital, Parma, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Coscelli
authors.forename: G
authors.initials: G
authors.lastname: Iacobellis
authors.forename: C
authors.initials: C
authors.lastname: Calderini
authors.forename: R
authors.initials: R
authors.lastname: Carleo
authors.forename: M
authors.initials: M
authors.lastname: Gobbo
authors.forename: U
authors.initials: U
authors.lastname: Di Mario
authors.forename: F
authors.initials: F
authors.lastname: Leonetti
authors.forename: A
authors.initials: A
authors.lastname: Galluzzo
authors.forename: V
authors.initials: V
authors.lastname: Pirrone
authors.forename: M
authors.initials: M
authors.lastname: Lunetta
authors.forename: P
authors.initials: P
authors.lastname: Casale
authors.forename: F
authors.initials: F
authors.lastname: Paleari
authors.forename: C
authors.initials: C
authors.lastname: Falcelli
authors.forename: D
authors.initials: D
authors.lastname: Valle
authors.forename: A
authors.initials: A
authors.lastname: Camporeale
authors.forename: D
authors.initials: D
authors.lastname: Merante
mesh_terms: D061265:Biphasic Insulins; D018592:Cross-Over Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000188:drug therapy*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy*; D004334:Drug Administration Schedule; D004435:Eating; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007279:Injections, Subcutaneous; D007328:Insulin / Q000008:administration & dosage* / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D061268:Insulin Lispro; D007336:Insulin, Isophane; D007558:Italy; D008297:Male; D008875:Middle Aged; D012107:Research Design; D013997:Time Factors
chemical_list: D061265:Biphasic Insulins; D007004:Hypoglycemic Agents; D007328:Insulin; D061268:Insulin Lispro; C482266:insulin lispro, isophane insulin lispro drug combination (25:75); D007336:Insulin, Isophane