title: Improved glycaemic control with reduced hypoglycaemic episodes and without weight gain using long-term modern premixed insulins in type 2 diabetes.
abstract: OBJECTIVE
  The primary goal of the study was to evaluate retrospectively efficacy of long-term modern premixed insulin (MPI) administration. The secondary aims were to monitor weight gain, hypoglycaemia and compliance during MPI therapy.
  
  
  METHODS
  One hundred and fifteen outpatients with type 2 diabetes (64 male patients, 51 female patients; mean age 62.4±12.2 years; mean duration of diabetes 10±8 years; mean weight 84.3±14.8 kg) were included in this study. Patients were prescribed one of three MPIs thrice-daily: biphasic insulin lispro 25, biphasic insulin lispro 50, or biphasic insulin aspart 30. Metformin was combined with MPI in 81 patients. Data prior to and during MPI treatment were retrieved from computerised patient medical files.
  
  
  RESULTS
  After a mean treatment period of 2.9±0.9 years, mean A1C levels and fasting blood glucose decreased from 8.7±1.4% and 193±59 mg/dl to 7.3±1.1% and 141±41 mg/dl (p<0.001 for both), respectively. Thirty-six per cent of the cohort achieved target A1C level of ≤7%. Serum triglycerides decreased from 183±109 mg/dl to 151±76 mg/dl (p<0.001). Weight did not change during MPI treatment. Frequency of minor hypoglycaemic episodes decreased significantly during MPI administration. No major hypoglycaemic event was reported. Number of incompliant patients decreased significantly from 39 to 25 (p=0.001) during MPI treatment.
  
  
  CONCLUSIONS
  Modern premixed insulins represent an effective and safe long-term therapy for patients with type 2 diabetes. Specifically, the regimen of thrice-daily injections combined with metformin is a viable treatment option.
authors.affiliation: Institute of Endocrinology, Chaim Sheba Medical Center, Tel Hashomer, Israel. shlevit@gmail.com
authors.forename: S
authors.initials: S
authors.lastname: Levit
authors.forename: Y
authors.initials: Y
authors.lastname: Toledano
authors.forename: J
authors.initials: J
authors.lastname: Wainstein
mesh_terms: D000368:Aged; D061265:Biphasic Insulins / Q000008:administration & dosage; D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D004338:Drug Combinations; D005215:Fasting / Q000097:blood; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D061268:Insulin Lispro / Q000008:administration & dosage; D061385:Insulins / Q000008:administration & dosage*; D008297:Male; D055118:Medication Adherence; D008687:Metformin / Q000008:administration & dosage; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D015430:Weight Gain / Q000187:drug effects
chemical_list: D061265:Biphasic Insulins; D001786:Blood Glucose; D004338:Drug Combinations; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D061268:Insulin Lispro; D061385:Insulins; D008687:Metformin