title: Effects of twice-daily injections of premixed insulin analog on glycemic control in type 2 diabetic patients.
abstract: OBJECTIVE
  Premixed insulin is effective to improve glycemic control; however, clinicians may be less likely to know which premixed insulin is appropriate for which patients. This study aimed to evaluate the effects of twice-daily injections of premixed insulin lispro on glycemic control in type 2 diabetic patients.
  
  
  METHODS
  Forty type 2 diabetic patients, who had been treated with twice-daily injections of human protamine mixture 30/70 insulin for at least 12 months, were divided into two groups; one group whose blood glucose 2 hours after breakfast was greater than 200 mg/dL, was switched to lispro mix50, and the other group whose blood glucose 2 hours after breakfast < 200 was switched to lispro mix25.
  
  
  RESULTS
  Glycated haemoglobin (HbA1c) significantly improved in the Mix50 group from 8.3% to 7.5% (at 12 weeks; p < 0.05), and to 7.5% (at 24 weeks; p < 0.05). On the other hand, HbA1c levels in the Mix25 group were slightly decreased from 8.1% to 7.7% at 12 weeks (p < 0.05), and to 7.9% at 24 weeks (not significant). Both postprandial plasma glucose and fasting plasma glucose levels were significantly improved in the Mix50 group, but not in the Mix25 group. Overall, 95% of subjects preferred premixed lispro insulin from human insulin in the viewpoint of the timing of insulin injection by questionnaire analysis.
  
  
  CONCLUSIONS
  Switching from human protamine mixture 30/70 insulin to lispro mix50 twice-daily injection therapy in patients with high postprandial plasma glucose could improve their glycemic control and quality of life.
authors.affiliation: Department of Endocrinology and Metabolism, Dokkyo Medical University School of Medicine, Tochigi, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shimizu
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Monden
authors.forename: Mihoko
authors.initials: M
authors.lastname: Matsumura
authors.forename: Nozomi
authors.initials: N
authors.lastname: Domeki
authors.forename: Kikuo
authors.initials: K
authors.lastname: Kasai
mesh_terms: D000368:Aged; D061265:Biphasic Insulins; D001786:Blood Glucose / Q000032:analysis*; D015992:Body Mass Index; D001835:Body Weight; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000008:administration & dosage / Q000031:analogs & derivatives*; D061268:Insulin Lispro; D007336:Insulin, Isophane; D008297:Male; D008875:Middle Aged; D019518:Postprandial Period; D011479:Protamines / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D061265:Biphasic Insulins; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin; D061268:Insulin Lispro; D007336:Insulin, Isophane; D011479:Protamines; C482266:insulin lispro, isophane insulin lispro drug combination (25:75)