title: Are insulin analogues an unavoidable necessity for the treatment of type 2 diabetes in developing countries? The case of Jordan.
abstract: Despite their reported benefits in terms of glycaemic control, insulin analogues are expensive for patients in developing countries. This study in Jordan aimed to compare the effectiveness and adverse events of premixed human insulin (BHI30) versus premixed insulin analogue (BIAsp30) in patients with type 2 diabetes. In a retrospective cohort study from October 2012 to March 2013, outcomes (HbA1c, weight, hypoglycaemia and lipohypertrophy) were compared at baseline and 6 months after treatment in 628 patients. BHI30 produced a significantly greater reduction in HbA1c than did BIAsp30. This difference in HbA1c remained significant after controlling for the effects of age, sex, duration of diabetes, body mass index and hypoglycaemia (β-coefficient was -0.18 in favour of BHI30). Weight gain and mild hypoglycaemia was significantly higher with BHI30 than with BIAsp30. BHI30 achieved better reduction in HbA1c compared with BIAsp30, with less cost, slightly more weight gain and greater reported mild hypoglycaemia.
authors.affiliation: National Center for Diabetes, Endocrinology and Genetics, Amman, Jordan.
authors.forename: D
authors.initials: D
authors.lastname: Hyassat
authors.affiliation: National Center for Diabetes, Endocrinology and Genetics, Amman, Jordan.
authors.forename: N
authors.initials: N
authors.lastname: Al Shekarchi
authors.affiliation: Department of Epidemiology and Public Health, Jordan University of Science and Technology, Amman, Jordan.
authors.forename: H
authors.initials: H
authors.lastname: Jaddou
authors.affiliation: National Center for Diabetes, Endocrinology and Genetics, Amman, Jordan.
authors.forename: M
authors.initials: M
authors.lastname: Liswi
authors.affiliation: National Center for Diabetes, Endocrinology and Genetics, Amman, Jordan.
authors.forename: M
authors.initials: M
authors.lastname: El-Khateeb
authors.affiliation: National Center for Diabetes, Endocrinology and Genetics, Amman, Jordan.
authors.forename: K M
authors.initials: KM
authors.lastname: Ajlouni
mesh_terms: D000368:Aged; D061265:Biphasic Insulins / Q000191:economics / Q000627:therapeutic use*; D003906:Developing Countries; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000191:economics / Q000627:therapeutic use*; D007328:Insulin / Q000191:economics / Q000627:therapeutic use*; D061267:Insulin Aspart / Q000191:economics / Q000627:therapeutic use*; D007336:Insulin, Isophane / Q000191:economics / Q000627:therapeutic use*; D007597:Jordan; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D061265:Biphasic Insulins; D007004:Hypoglycemic Agents; D007328:Insulin; C557564:insulin aspart, insulin aspart protamine drug combination 30:70; D007336:Insulin, Isophane; D061267:Insulin Aspart