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When glycaemic targets can no longer be achieved with basal insulin in type 2 diabetes, can simple intensification with a modern premixed insulin help? Results from a subanalysis of the PRESENT study

Cited 35 time in Web of Science Cited 37 time in Scopus
Authors
Jang, Hak Chul; Guler, S; Shestakova, M
Issue Date
2008-05-16
Publisher
Wiley-Blackwell
Citation
Int J Clin Pract. 2008; 62(7): 1013-1018
Keywords
AdultAgedBlood Glucose/metabolismDiabetes Mellitus, Type 2/blood/*drug therapyFemaleHemoglobin A, Glycosylated/metabolismHumansHypoglycemic Agents/*therapeutic useInsulin/*analogs & derivatives/therapeutic useMaleMiddle AgedProspective StudiesTreatment FailureTreatment Outcome
Abstract
AIMS: The aim of this analysis was to assess the efficacy and safety of intensifying insulin therapy from a basal-only regimen to biphasic insulin aspart 30 (BIAsp 30) in patients with type 2 diabetes previously failing to reach glycaemic targets. METHODS AND PATIENTS: The analysis is based on data from a subpopulation of the Physicians' Routine Evaluation of Safety and Efficacy of NovoMix 30 Therapy (PRESENT) study, which was a 6-month observational study in 15 countries. This subanalysis included patients previously receiving long-acting analogue insulin (AB; n = 348), or human basal insulin (long and intermediate acting) (HB; n = 3414), who were transferred to BIAsp 30. Efficacy end-points included change in glycated haemoglobin (HbA(1c)), fasting plasma glucose (FPG) and postprandial plasma glucose (PPG), from baseline to the end of the study. Episodes of hypoglycaemia, adverse events, and physician and patient satisfaction were also recorded. End-points were considered separately by previous basal regimen (AB or HB). RESULTS: After 6 months' treatment with BIAsp 30, HbA(1c) was significantly lowered in both groups (-1.60% and -1.42% in the AB and HB groups; p < 0.0001 compared with baseline). Reductions in FPG and PPG were also statistically significant in both groups. The rate (events/patient/year) of overall hypoglycaemia remained relatively constant in patients switching from AB, but it was statistically lower in patients switching from HB (change from baseline -3.8; p < 0.001). CONCLUSION: In routine clinical practice, patients with type 2 diabetes who are failing to reach glycaemic targets on basal insulin can achieve better glycaemic control without an increase in overall hypoglycaemia by intensifying with BIAsp 30.
ISSN
1742-1241 (Electronic)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18479365

https://hdl.handle.net/10371/68234
DOI
https://doi.org/10.1111/j.1742-1241.2008.01792.x
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College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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