Premixed Insulin vs. Basal-Bolus Regimen for Glycemic Control
(HealthDay News) — For hospitalized patients with diabetes, treatment with premixed insulin results in similar glycemic control but higher frequency of hypoglycemia compared with a basal-bolus regimen, according to a study published online October 12 in Diabetes Care.
Virginia Bellido, from Hospital Universitario Central de Asturias in Spain, and colleagues conducted a prospective, open-label trial in which inpatients with diabetes were randomized to receive a basal-bolus regimen with glargine once daily and glulisine before meals (33 patients) or premixed human insulin twice daily (30% regular insulin, 70% NPH insulin; 39 patients).
The study was stopped prematurely at the first prespecified interim analysis because of an increased frequency of hypoglycemia >50% in patients treated with premixed human insulin. The researchers found that 64 and 24% of patients treated with premixed insulin and a basal-bolus regimen, respectively, experienced one or more episodes of hypoglycemia (P<0.001). After the first day of treatment, there were no differences seen in mean daily blood glucose level between the groups. In 55.9% of blood glucose readings in the basal-bolus group and 54.3% in the premixed insulin group, a blood glucose target between 80–180mg/dL before meals was achieved (P=0.23).
"Inpatient treatment with premixed human insulin resulted in similar glycemic control but in significantly higher frequency of hypoglycemia compared with treatment with basal-bolus insulin regimen in hospitalized patients with diabetes," the authors write.
Several authors disclosed financial ties to pharmaceutical companies, including Sanofi-Aventis, which funded the study.