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Humalog ® Mix50™ before carbohydrate‐rich meals in type 2 diabetes mellitus
Author(s) -
Roach P.,
Arora V.,
Campaigne B. N.,
Mattoo V.,
Rangwala S.
Publication year - 2003
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1046/j.1463-1326.2003.00277.x
Subject(s) - postprandial , morning , meal , medicine , evening , crossover study , insulin , type 2 diabetes , diabetes mellitus , zoology , endocrinology , placebo , physics , alternative medicine , pathology , astronomy , biology
Aim: To compare pre‐meal injection of Humalog ® Mix50™ (Mix50) and Humalog ® Mix25™ (Humalog ® Mix75/25™ in the US; Mix25) with respect to 2 h postprandial (2 h pp) blood glucose (BG) control after a carbohydrate‐rich breakfast in patients with type 2 diabetes. Research Design and Methods: One hundred and sixteen patients were enrolled in a 16‐week crossover trial and received two treatment regimens in a randomized crossover fashion: (i) Mix50 before breakfast and Mix25 before the evening meal (Mix50/Mix25) and (ii) Mix25 before both breakfast and the evening meal (Mix25 twice daily). Insulin doses were adjusted according to stated glycaemic targets. After 6 and 8 weeks of treatment, the patient's usual morning insulin dose was administered, followed immediately by a test breakfast representative of the patient's usual breakfast meal. Fasting and 2 h pp BG concentrations were measured at the time of the test meal. Haemoglobin A1c (A1C) was measured, and information regarding hypoglycaemia (symptoms) was collected at the end of each treatment period. Results: Insulin doses were similar between treatments (morning = 31–33 U, evening = 26–28 U) at endpoint. Following the test breakfast, the 2 h pp BG was lower (10.9 ± 0.3 mmol/l vs. 12.4 ± 0.3 mmol/l, p = 0.0012) and the 2 h pp BG excursion was smaller (1.4 ± 0.28 mmol/l vs. 3.5 ± 0.28 mmol/l, p < 0.001) during treatment with Mix50/Mix25 than during treatment with Mix25 twice daily. There was no difference between the treatments with respect to fasting BG (Mix50/Mix25, 9.5 ± 0.3 mmol/l vs. Mix25 twice daily, 8.9 ± 0.3 mmol/l; p = NS), A1C (8.14% ± 1.14% vs. 8.14% ± 1.07%; p = NS) or the incidence of self‐reported hypoglycaemia (34% vs. 23%; p = NS). Conclusions: Compared with treatment with Mix25 twice daily, treatment with Mix50 before breakfast and Mix25 before the evening meal resulted in better pp glycaemic control following a carbohydrate‐rich meal, and similar fasting BG, A1C and incidence of hypoglycaemia in patients with type 2 diabetes.