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Higher morning to evening ratio in total dose of twice-daily biphasic insulin analog might be effective in achieving glucose control in patients with poorly controlled type 2 diabetes.

Authors
 Yong-Ho Lee  ;  Byung-Wan Lee  ;  Hea Jin Kwon  ;  Eun Seok Kang  ;  Bong Soo Cha  ;  Hyun Chul Lee 
Citation
 DIABETES TECHNOLOGY & THERAPEUTICS, Vol.14(6) : 508-514, 2012 
Journal Title
 DIABETES TECHNOLOGY & THERAPEUTICS 
ISSN
 1520-9156 
Issue Date
2012
MeSH
Asian Continental Ancestry Group ; Biphasic Insulins/administration & dosage* ; Biphasic Insulins/pharmacokinetics ; Blood Glucose/drug effects* ; Blood Glucose/metabolism ; Blood Glucose Self-Monitoring ; Cholesterol/blood* ; Diabetes Mellitus, Type 2/blood ; Diabetes Mellitus, Type 2/drug therapy* ; Drug Administration Schedule ; Female ; Glycated Hemoglobin A ; Humans ; Hypoglycemic Agents/administration & dosage* ; Hypoglycemic Agents/pharmacokinetics ; Injections ; Insulin-Secreting Cells/drug effects* ; Insulin-Secreting Cells/metabolism ; Male ; Middle Aged ; Postprandial Period ; Time Factors ; Treatment Outcome ; Triglycerides/blood*
Keywords
Asian Continental Ancestry Group ; Biphasic Insulins/administration & dosage* ; Biphasic Insulins/pharmacokinetics ; Blood Glucose/drug effects* ; Blood Glucose/metabolism ; Blood Glucose Self-Monitoring ; Cholesterol/blood* ; Diabetes Mellitus, Type 2/blood ; Diabetes Mellitus, Type 2/drug therapy* ; Drug Administration Schedule ; Female ; Glycated Hemoglobin A ; Humans ; Hypoglycemic Agents/administration & dosage* ; Hypoglycemic Agents/pharmacokinetics ; Injections ; Insulin-Secreting Cells/drug effects* ; Insulin-Secreting Cells/metabolism ; Male ; Middle Aged ; Postprandial Period ; Time Factors ; Treatment Outcome ; Triglycerides/blood*
Abstract
BACKGROUND: The aims of this study are to investigate not only the glucose-lowering effectiveness of twice-daily premixed insulin lispro 25 (Humalog(®) Mix25(™), Eli Lilly and Co., Indianapolis, IN), but also the optimal divided ratio of total Mix25 dose in Korean patients with poorly controlled type 2 diabetes. SUBJECTS AND METHODS: In this retrospective study, we retrieved data for subjects who were on intensive insulin therapy with twice-daily Mix25 regimen for at least 24 weeks. Changes of hemoglobin A1c (HbA(1c)) and other clinical and laboratory parameters were evaluated. Two groups were defined according to dose ratio of pre-breakfast to pre-dinner insulin at 24 weeks: Group I, pre-breakfast:pre-dinner insulin dose ratio=50:50; Group II, ratio=53:47-75:25. RESULTS: In total, 143 subjects were ultimately analyzed in this study. Twice-daily Mix25 significantly improved HbA(1c) levels from 10.1% to 7.7%, and 34% of patients had reached the target glycemic goal (HbA(1c)<7%) after 24 weeks. Compared with Group I, a significant reduction in HbA(1c) (Group I vs. Group II, -1.9±0.3% vs. -2.8±0.3%, P=0.02) and a larger proportion of subjects with HbA(1c)<7% (23.2% vs. 46.7%, P=0.01) were observed in subjects in Group II. Among clinical and laboratory factors, duration of diabetes (odd ratios [OR]=0.93, 95% confidence interval [CI] 0.86-0.99, P=0.04) and history of sulfonylurea use (OR=0.27, 95% CI 0.10-0.72, P=0.01) were independently associated with achieving target HbA(1c) levels less than 7%. CONCLUSIONS: Twice-daily Mix25 is an effective option for Korean subjects with type 2 diabetes having uncontrolled hyperglycemia. A higher pre-breakfast/pre-dinner dose ratio (53:47-75:25) might be taken into consideration as an initial protocol to accomplish better glycemic control in twice-daily Mix25.
Full Text
http://online.liebertpub.com/doi/abs/10.1089/dia.2011.0208
DOI
22376081
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Eun Seok(강은석) ORCID logo https://orcid.org/0000-0002-0364-4675
Lee, Byung Wan(이병완) ORCID logo https://orcid.org/0000-0002-9899-4992
Lee, Yong Ho(이용호) ORCID logo https://orcid.org/0000-0002-6219-4942
Lee, Hyun Chul(이현철)
Cha, Bong Soo(차봉수) ORCID logo https://orcid.org/0000-0003-0542-2854
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/90122
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