Literature DB >> 19285933

Self-titration of biphasic insulin aspart 30/70 improves glycaemic control and allows easy intensification in a Dutch clinical practice.

Robert J Ligthelm1.   

Abstract

AIMS: This 18-month study assessed the improvement in glycaemic control and proportion of patients reaching glycated haemoglobin (HbA(1c)) targets with biphasic insulin aspart 30/70 (BIAsp 30) in clinical practice.
METHODS: Type-2 diabetes patients failing on oral antidiabetic drugs (n=90) or existing insulin regimens (n=59) started or switched to BIAsp 30. Thiazolidinediones were stopped, metformin was continued. BIAsp 30 was given once daily (n=41), twice daily (n=96), or three times daily (n=12). Patients were taught self-monitoring and self-titration using an algorithm, adding daily doses of BIAsp 30 when necessary.
RESULTS: Mean baseline HbA(1c) was 8.4%, weight 85.4 kg, and age 57.9 years. All patients experienced significant reductions in HbA(1c) (mean 1.9%+/-0.1), fasting plasma glucose (mean 2.8 mmol/l), and post-prandial glycaemia (mean 2.9 mmol/l); 91% of patients achieved HbA(1c)<7% and 52% achieved HbA(1c) < or=6.5%. No major or nocturnal hypoglycaemia were reported; 15% of patients reported minor hypoglycaemia. Insulin-naïve patients gained mean 2.7 kg; patients who switched from another insulin lost weight (mean -0.6kg).
CONCLUSION: The results from this study from routine care suggest that BIAsp 30 may allow a large proportion of type-2 diabetes patients (90%) to improve glycaemic control and reach target HbA(1c)<7%, using self-titration.

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Year:  2009        PMID: 19285933     DOI: 10.1016/j.pcd.2009.01.003

Source DB:  PubMed          Journal:  Prim Care Diabetes        ISSN: 1878-0210            Impact factor:   2.459


  8 in total

Review 1.  Ten years of experience with biphasic insulin aspart 30: from drug development to the latest clinical findings.

Authors:  Andreas Liebl; Vinay Prusty; Paul Valensi; Ryuzo Kawamori; Jens Sandahl Christiansen; Andrew J Palmer; Per Balschmidt; Robert Ligthelm; Viswanathan Mohan
Journal:  Drugs       Date:  2012-07-30       Impact factor: 9.546

2.  An educational program for insulin self-adjustment associated with structured self-monitoring of blood glucose significantly improves glycemic control in patients with type 2 diabetes mellitus after 12 weeks: a randomized, controlled pilot study.

Authors:  Daniel Dutra Romualdo Silva; Adriana Aparecida Bosco
Journal:  Diabetol Metab Syndr       Date:  2015-01-15       Impact factor: 3.320

Review 3.  Drug-related risk of severe hypoglycaemia in observational studies: a systematic review and meta-analysis.

Authors:  Marcin Czech; Elżbieta Rdzanek; Justyna Pawęska; Olga Adamowicz-Sidor; Maciej Niewada; Michał Jakubczyk
Journal:  BMC Endocr Disord       Date:  2015-10-12       Impact factor: 2.763

4.  An RCT Investigating Patient-Driven Versus Physician-Driven Titration of BIAsp 30 in Patients with Type 2 Diabetes Uncontrolled Using NPH Insulin.

Authors:  Abdelmjid Chraibi; Shoorook Al-Herz; Bich Dao Nguyen; Djoko W Soeatmadji; Anil Shinde; Balasubramanian Lakshmivenkataraman; Samir H Assaad-Khalil
Journal:  Diabetes Ther       Date:  2017-05-18       Impact factor: 2.945

5.  Practical guidance on intensification of insulin therapy with BIAsp 30: a consensus statement.

Authors:  A G Unnikrishnan; J Tibaldi; M Hadley-Brown; A J Krentz; R Ligthelm; T Damci; J Gumprecht; L Gero; Y Mu; I Raz
Journal:  Int J Clin Pract       Date:  2009-09-19       Impact factor: 2.503

6.  Insulin degludec in a simple or stepwise titration algorithm in a Japanese population of patients with type 2 diabetes: a randomized, 26-week, treat-to-target trial.

Authors:  Takashi Kadowaki; Hideaki Jinnouchi; Kohei Kaku; Malene L Hersløv; Jacob Hyllested-Winge; Shuji Nakamura
Journal:  Diabetol Int       Date:  2016-09-02

7.  Subject-driven titration of biphasic insulin aspart 30 twice daily is non-inferior to investigator-driven titration in Chinese patients with type 2 diabetes inadequately controlled with premixed human insulin: A randomized, open-label, parallel-group, multicenter trial.

Authors:  Wenying Yang; Lvyun Zhu; Bangzhu Meng; Yu Liu; Wenhui Wang; Shandong Ye; Li Sun; Heng Miao; Lian Guo; Zhanjian Wang; Xiaofeng Lv; Quanmin Li; Qiuhe Ji; Weigang Zhao; Gangyi Yang
Journal:  J Diabetes Investig       Date:  2015-05-25       Impact factor: 4.232

8.  Comparison of Blood Glucose Variability Between Exenatide and Biphasic Insulin Aspart 30 in Chinese Participants with Type 2 Diabetes Inadequately Controlled with Metformin Monotherapy: A Multicenter, Open-Label, Randomized Trial.

Authors:  Li Wang; Xiangyang Liu; Wenjuan Yang; Jingbo Lai; Xinwen Yu; Jianrong Liu; Xiling Gao; Jie Ming; Kaiyan Ma; Jing Xu; Zhufang Tian; Qingzhen He; Qiuhe Ji
Journal:  Diabetes Ther       Date:  2020-08-27       Impact factor: 2.945

  8 in total

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