In a nutshell
This trial compared the effectiveness of three insulin regimens for the treatment of uncontrolled type 2 diabetes.
Some background
Many type 2 diabetic patients begin insulin treatment when other methods of controlling blood glucose levels fail. Several insulin drugs and combinations may be used in the treatment of diabetes. Most commonly, premixed insulin is prescribed. Premixed insulin is a mixture of two different types of insulin. One long lasting insulin drug intended to reduce glucose levels in between meals (referred to as a basal insulin), and a short acting insulin intended to reduce glucose levels immediately after meals. Premixed insulin injections are received twice daily. Another treatment option includes an injection of basal insulin alone, plus further injections of short acting insulin during mealtimes. Few studies have directly compared these regimens in the treatment of type 2 diabetes.
Methods & findings
582 patients with uncontrolled diabetes were assigned to receive either twice daily premixed insulin injections (PM-2 group), once-daily long acting basal insulin injection plus one short acting insulin injection at the time of the main meal (G+1 group), or once-daily long acting basal insulin injection plus a short acting insulin injection at each of the three daily meals (G+3 group).
Results showed that glycemic control was significantly improved in all three treatment groups. Patients in the G+3 group showed only slightly better glycemic control after 60 weeks of treatment compared to patients treated with PM-2 or G+1. G+1 was found to be as effective as PM-2 at achieving glycemic control.
The incidence of hypoglycemia (dangerously low blood glucose levels), a common side effect of insulin injections, was also compared between the treatment groups. Patients treated with PM-2 experienced significantly more episodes of hypoglycemia compared to patients treated with G+1 or G+3.
The bottom line
This study concluded that a G+1 insulin regimen is the most pragmatic choice as treatment for uncontrolled type 2 diabetic patients due to similar effectiveness compared to other regimens, a reduced risk of hypoglycemia and a relatively small number of daily injections.
What’s next?
Consult with your doctor regarding various insulin regimens used in the treatment of type 2 diabetes.
Published By :
Diabetes, Obesity and Metabolism
Date :
Oct 11, 2013
