title: Evaluation of a Premixed Insulin Analog Suspension in Japanese People with Type 2 Diabetes and the Clinical Importance of Improved Injection Techniques: A Cross-Sectional Pilot Study.
abstract: BACKGROUND
  Patients with type 2 diabetes, who live in Asian countries, often use premixed insulin analogs. However, if these solutions are insufficiently mixed prior to use, patients will receive inaccurate doses of intermediate- and/or short-acting insulin, which could affect diabetes control. This study aimed to determine whether insulin users were correctly resuspending premixed insulin analog solutions prior to use.
  
  
  METHODS
  We investigated whether Japanese patients with type 2 diabetes were correctly resuspending their premixed insulin analog solutions by assessing the optical densities (ODs) of the solutions.
  
  
  RESULTS
  Among 476 patients who used premixed insulin analogs, we found that the ODs of residual insulin differed significantly from the control values, particularly for high-mix insulin suspensions.
  
  
  CONCLUSIONS
  Our findings suggest that patients should be educated about the importance of properly resuspending these insulin analog solutions prior to use.
  
  
  BACKGROUND
  University Hospital Medical Information Network (UMIN No. 000022329).
authors.affiliation: Department of Endocrinology and Metabolism, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Simotsugagun, Tochigi, 321-0293, Japan. kuni-s@dokkyomed.ac.jp.
authors.forename: Kunihiro
authors.identifier: http://orcid.org/0000-0002-1287-304X
authors.initials: K
authors.lastname: Suzuki
authors.affiliation: Department of Endocrinology and Metabolism, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Simotsugagun, Tochigi, 321-0293, Japan.
authors.forename: Chie
authors.initials: C
authors.lastname: Aoki
authors.affiliation: Department of Endocrinology and Metabolism, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Simotsugagun, Tochigi, 321-0293, Japan.
authors.forename: Kanako
authors.initials: K
authors.lastname: Kato
authors.affiliation: Department of Endocrinology and Metabolism, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Simotsugagun, Tochigi, 321-0293, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Shimizu
authors.affiliation: Department of Endocrinology and Metabolism, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Simotsugagun, Tochigi, 321-0293, Japan.
authors.forename: Shintaro
authors.initials: S
authors.lastname: Sakurai
authors.affiliation: Department of Endocrinology and Metabolism, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Simotsugagun, Tochigi, 321-0293, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Yanagi
authors.affiliation: Department of Endocrinology and Metabolism, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Simotsugagun, Tochigi, 321-0293, Japan.
authors.forename: Hisamoto
authors.initials: H
authors.lastname: Kuroda
authors.affiliation: Department of Endocrinology and Metabolism, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Simotsugagun, Tochigi, 321-0293, Japan.
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Aso
keywords: Diabetes control; Optical density; Premixed insulin analogs; Type 2 diabetes