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Objective To study the analysis of insulin glargine combined with acarbose in type 2 diabetes compared with pre mixed insulin treatment efficacy and safety. Methods 100 patients with type 2 diabetes mellitus treated in our hospital from March 2015 to August 2016 were selected and randomly divided into the control group and the experimental group, with 50 patients in each group. The control group were treated with premixed insulin treatment, the experimental group were treated with basal insulin combined with acarbose. The clinical indexes of the experimental group and the control group were compared and analyzed. Results After the corresponding treatment, the fasting blood glucose level of the control group was (7.56 ± 1.13) nmol / L, and the fasting blood glucose level of the experimental group was (7.01 ± 0.92) nmol / L. The level of fasting blood glucose in the experimental group was significantly lower than that in the control group, with statistical difference (P<0.05). The level of HbA1c in the experimental group was (7.01 ± 0.82)％, significantly lower than that in the control group, and the level of HbA1c (7.45 ± 0.91)％, with statistical difference (P<0.05). Among the 50 patients in the control group, hypoglycemia occurred in 20 patients, the incidence of hypoglycemia was 40％, significantly higher than that in the experimental group, and the incidence of hypoglycemia was 14％, which was statistically significant (P<0.05). Conclusion Basal insulin combined with acarbose compared with premixed insulin treatment of type 2 diabetes treatment can significantly hypoglycemic effect, high safety, with further clinical promotion and application significance.
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OBJECTIVE:To systematically review the efficacy and safety of insulin glargine versus premixed insulin in treat-ment of type 2 diabetes,and provide evidence-based reference for clinical treatment. METHODS:Retrieved from PubMed,CJFD, Wanfang Database and VIP Database,the randomized controlled trials(RCT)about the efficacy and safety of premixed insulin ver-sus insulin glargine in the treatment of type 2 diabetes were collected. Meta-analysis was performed by using Rev Man 5.0 statistics software after extracting data and evaluating quality by modified Jadad. RESULTS:A total of 10 RCTs were enrolled,involving 1 655 patients. Results of Meta-analysis showed that insulin glargine was better than premixed insulin on reducing glycated hemoglobin [M=-0.41,95% CI(-0.64,-0.18),P<0.001] and fasting blood glucose [MD=-0.51,95% CI(-0.99,-0.02),P=0.04], there were significantly differences between 2 groups,and there were no significantly differences in reducing 2 h postprandial blood glucose [MD=-0.56,95% CI(-1.21,0.09),P=0.09] and body mass index [MD=-0.52,95% CI(-1.52,0.48),P=0.31];the incidence of hypoglycemia in insulin glargine group was significantly lower than premixed insulin,there were significantly differ-ences between 2 groups [RR=0.65,95%CI(0.46,0.90),P=0.01]. CONCLUSIONS:The efficacy and safety of insulin glargine are better than premixed insulin in the treatment of type 2 diabetes.
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Objective To observe the effectiveness and safety of basal insulin plus oral antidiabetic drugs (OADs) in treating the patients with type 2 diabetic mellitus (T2DM ) ,who were poor blood sugar control by premixed insulin with or without OADs . Methods 32 cases of T2DM and poor blood sugar control by premixed insulin combinated with or without OADs stopped the premixed insulin therapy and changed to insulin glargine plus OADs for 16 weeks .Glycosylated haemoglobin (HbA1c) ,fasting blood glucose(FBG) ,postprandial blood glucose(PBG) ,body mass index (BMI) and mean daily insulin dose were compared among patients .And the episodes of hypoglycemia events were recorded .Results After 16‐week treatment ,HbA1c ,FBG ,PBG and BMI were all significantly decreased comapared with before treatment (P<0 .01) .The mean insulin glargine daily dose was significantly decreased compared with the premixed insulin dose at admission .2 cases (6% )appeared twice hypoglycemia episodes during the treatment period ,all were general hypoglycemia .Conclusion Basal insulin once daily can effectively improve the sugar metabolism in T2DM patients failed by premixed insulin with or without OADs ,moreover the body mass is not increased .
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Premixed insulin is currently the most popular insulin starter in China.According to the different ratios of basal and prandial components,premixed insulin analogues could be classified into low-and midmixtures.The former is now mainly used as insulin starter in the patients with type 2 diabetes mellitus after the failure of monotherapy or combination with oral antidiabetic drugs,while the later is usually used as simplified intensive insulin treatment in patients with type 2 diabetes mellitus inadequately controlled on insulin once-or twice-daily.
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[Summary] The general status of glycemic control and insulin initiation are not optimistic in Chinese patients with type 2 diabetes.Chinese patients experience pancreatic β-cell dysfunction and reduction of early phase insulin spike earlier and more severely compared to Caucasians.These can cause more significant postprandial hyperglycaemia which is further deteriorated by traditional carbohydrate-rich Chinese diet.Therefore,premixed insulin may be a more appropriate option of insulin initiation therapy for Chinese patients with type 2 diabetes mellitus.
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Objective 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. Methods 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.Results BIAsp 30 was as effective as BHI 30 in controling 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/Lvs.(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). Conclusion 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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To observe the patients with type 2 diabetes who were injected premixed insulin analogues after short time continuous subcutaneous insulin infusion( CSII ) treatment.It was found that the patients needed premixed insulin analogue injection 2 times daily when the dosage of CSII was less than 45 U/d,and 3 times daily when the dosage was greater than 45 U/d.The relationship of dosages between premixed insulin analogue treatment ( Y ) and CSII treatment(X) was calculated by following equations:2 times daily premixed insulin analogue treatment:Y =13.093 +0.395X,3 times daily premixed insulin analogue treatment:Y =23.114+0.405X.