Abstract

Objective To observe whether there are sexual-related differences in response to mid- or low-premixed insulin in type 2 diabetic patients. Methods This was an analysis of CGM data of a previous study. After screening, patients with longstanding T2D receive a 7-day continuous subcutaneous insulin infusion (CSII) therapy, and then subjects were randomly assigned 1 : 1 into two groups receiving Novo Mix 30 or Humalog Mix 50 regimen for a 2-day phage, followed by a 4-day cross-over period. A 4-day continuous glucose monitoring (CGM) was performed during the cross-over period. The primary endpoint was the differences in glycemic control between male and female patients receiving mid- or low-premixed insulin therapy. Results A total of 102 patients (52 men and 50 women) completed the study. Our data showed that male patients had significant decrease in mean glucose levels monitored by CGM after three meals during Humalog Mix 50 treatment period compared to those received Novo Mix 30 regimen (0900: 11.0 ± 2.5 vs. 12.2 ± 2.8, 1000: 9.9 ± 2.9 vs. 11.3 ± 3.1, 1200: 8.0 ± 1.9 vs. 9.1 ± 2.5, 1400: 9.2 ± 2.3 vs. 10.3 ± 2.5, and 2000: 7.3 ± 2.1 vs. 8.2 ± 2.4 mmol/L, p < 0.05, respectively). In addition, male patients receiving Novo Mix 30 experienced a significantly increased hypoglycemic duration compared to those of receiving Humalog Mix 50 (0 (0, 4.8) vs. 0 (0, 0), p < 0.05, respectively). In addition, male patients receiving Novo Mix 30 experienced a significantly increased hypoglycemic duration compared to those of receiving Humalog Mix 50 (0 (0, 4.8) vs. 0 (0, 0), Conclusion Our data indicate that male patients with T2D receiving mid-premixed insulin analogue regimen may have a potential benefit of improvement in glycemic control compared to female patients. This trial is registered with ClinicalTrials.gov ChiCTR-IPR-15007340.

Highlights

  • Premixed insulin analogues are an optional choice for patients with type 2 diabetes (T2D) to maintain their blood glucose concentrations in the target range [1]

  • We expected to see a significant decrease in postprandial glucose levels in patients receiving Humalog Mix 50 regimen compared to Novo mix 30 twice daily therapy

  • Our data showed that longstanding T2D patients may have a potential benefit in improvement of postprandial glucose levels receiving mid-premixed insulin analogue compared to those of low-premixed insulin analogue therapy

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Summary

Introduction

Premixed insulin analogues are an optional choice for patients with type 2 diabetes (T2D) to maintain their blood glucose concentrations in the target range [1]. A phase 4 randomized trial reported that low- or midpremixed insulin analogue as insulin initiations showed similar effect on improving glycemic control in patients with T2D. Researchers found that more patients receive mid-premixed insulin regimen achieving target HbA1c levels than those of low-premixed insulin analogue [3], which indicated that mid-premixed insulin may have potential effect on long-run glycemic control on some patients with special characteristics. We demonstrated that male patients with longstanding T2D need lower total, basal, and bolus insulin doses to maintain their blood glucose control compared to those of female patients. Estradiol levels were positively correlated to insulin resistance in female patients with T2D [9], Journal of Diabetes Research

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