Abstract

To compare the blood glucose levels and variability of premixed insulin aspart (BIAsp 30) with human insulin premix (BHI 30) used in a twice a day injection regimen in elderly type 2 diabetes patients. 52 cases of inadequate glycemia controlled by oral anti-diabetic drugs were randomly divided into two groups, treated on a twice-daily regimen with BIAsp 30 (n = 26) and BHI 30 (n = 26) respectively. After achieving the target goal, a continuous glucose monitoring system (CGMS) was used to compare the blood glucose levels, blood glucose fluctuant coefficient (BGFC), postprandial glucose excursion (PPGE), and occurrence of hypoglycemia. BIAsp 30 was as effective as BHI 30 in control glycaemia. Detected by CGMS, there was no statistical differences in blood glucose levels among pre-three main meals, post-lunch and the mean blood glucose (MBG) (all P > 0.05). The BGFC levels were significantly lower in the BIAsp 30 group than in the BHI 30 group [(1.69 ± 0.42) mmol/L vs. (2.07 ± 0.51) mmol/L, t = -3.013, P < 0.01]. The blood glucose increment over breakfast, dinner and the percentage of time at hyperglycaemia (BG > 11.1 mmol/L) were lower in the BIAsp 30 group than in the BHI 30 group [(2.89 ± 1.32) mmol/L vs. (3.83 ± 1.18) mmol/L, t = -2.705, P < 0.01; (2.69 ± 1.37) mmol/L vs. (3.55 ± 1.40) mmol/L, t = -2.232, P < 0.05; (6.21 ± 6.04)% vs. (10.01 ± 6.80)%, t = -2.132, P < 0.05]. The frequency of hypoglycemia was lower in the BIAsp 30 group than in the BHI 30 group, but there was no statistical difference (P > 0.05). Pre-meal injection of BIAsp 30 in a twice-daily regimen could significantly improve the control of postprandial glucose level and reduce the overall glucose excursions so as to lower the risk of hypoglycaemia when compared to BHI 30.

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