title: Improvement of postprandial hyperglycemia and arterial stiffness upon switching from premixed human insulin 30/70 to biphasic insulin aspart 30/70.
abstract: Postprandial hyperglycemia is known to be associated with increasing cardiovascular mortality in type 2 diabetes mellitus patients. Cardio-ankle vascular index (CAVI) reflects arterial stiffness and is more useful for predicting coronary atherosclerosis than intima-media thickness. Premixed human insulin 30/70 (BHI30) containing rapid-acting insulin has been used conventionally as a biphasic insulin. Recently, a biphasic insulin analogue preparation, biphasic insulin aspart 30/70 (BIAsp30), containing ultrarapid-acting insulin has been approved and expected to improve postprandial hyperglycemia. The aim of this study was to clarify the effects of switching the biphasic insulin from BHI30 to BIAsp30 on arterial stiffness in type 2 diabetes mellitus patients. Twenty-six type 2 diabetes mellitus patients (glycosylated hemoglobin >6.5%) who were already receiving biphasic insulin therapy with BHI30 twice daily were observed for 3 months. Afterward, BHI30 was switched to BIAsp30. At 3 months after switching, relative mobility of the peak of LDL fraction decreased significantly (from 0.3462 ± 0.041 to 0.3356 ± 0.035, P < .01); and CAVI also decreased significantly (from 9.77 ± 1.11 to 9.35 ± 1.17 m/s, P < .005). A significant negative correlation was observed between the change in CAVI and change in 1,5-anhydroglucitol (1,5-AG) (r = -0.3929, P < .05). A stronger correlation between change in CAVI and change in 1,5-AG was observed in the subgroup of patients whose 1,5-AG levels were elevated after switching (r = -0.6261, P < .05) compared with all subjects. These results suggest that switching biphasic insulin from BHI30 to BIAsp30 improves arterial stiffness, and the improvement of arterial stiffness may be associated with improvement of postprandial hyperglycemia.
authors.affiliation: Center of Diabetes, Endocrine and Metabolism, Sakura Hospital Medical Center, Toho University, Chiba 285-0841, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ohira
authors.forename: Kei
authors.initials: K
authors.lastname: Endo
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Oyama
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Noriko
authors.initials: N
authors.lastname: Ban
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Kawana
authors.forename: Daiji
authors.initials: D
authors.lastname: Nagayama
authors.forename: Ayako
authors.initials: A
authors.lastname: Nagumo
authors.forename: Atsuhito
authors.initials: A
authors.lastname: Saiki
authors.forename: Takeyoshi
authors.initials: T
authors.lastname: Murano
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Watanabe
authors.forename: Yoh
authors.initials: Y
authors.lastname: Miyashita
authors.forename: Kohji
authors.initials: K
authors.lastname: Shirai
mesh_terms: D000368:Aged; D001158:Arteries / Q000503:physiopathology; D061265:Biphasic Insulins; D003847:Deoxyglucose / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy* / Q000503:physiopathology; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D061267:Insulin Aspart; D007336:Insulin, Isophane; D008297:Male; D008875:Middle Aged
chemical_list: D061265:Biphasic Insulins; D007004:Hypoglycemic Agents; D007328:Insulin; C557564:insulin aspart, insulin aspart protamine drug combination 30:70; D007336:Insulin, Isophane; C006584:1,5-anhydroglucitol; D003847:Deoxyglucose; D061267:Insulin Aspart