Sustainable glycemic control with combination insulin therapy of biphasic insulin plus rapid-acting insulin mimicking physiologic insulin secretion in type 2 diabetes.
- Author:
Nestor Eric R LAPLANO
;
Leilani B MERCADO-ASIS
- Publication Type:Journal Article, Original
- Keywords:
Sustainability Of Glycemic ControlInsulin TherapyBiphasic InsulinInsulin, Short-actingInsulin Secretion34 To 77 Years Old
- MeSH:
Human;
Male;
Female;
Aged;
Middle Aged;
Adult;
Diabetes Mellitus, Type 2;
Diabetes Mellitus;
Glucose Metabolism Disorders;
Metabolic Diseases;
Nutritional And Metabolic Diseases;
Biphasic Insulins;
Drug Combinations;
Insulin, Regular, Human
- From:
Philippine Journal of Internal Medicine
2012;50(3):1-6
- CountryPhilippines
-
Abstract:
Objective: To describe sustainability of glycemic control of more than one year in Filipino patients with type 2 diabetes who are on combinationtwice-daily pre-mixed human insulin plus thrice-daily insulin analog.Research Design and Methods: This is a descriptive, retrospective analysis of 327 outpatient charts of Filipinos with type 2 diabetes who are on combination insulin regimen. We included patients who achieved optimal glycemic control and excluded those with diabetes complications, hepatic/renal impairment, and those with conditions affecting HbA1c levels and carbohydrate metabolism. Sustainability was based on duration that glycemic control is maintained.Results: One hundred thirty-eight patients (99 females, 39 males) achieved target HbA1c from baseline (9.7±2.2%) up to follow-up (6.8±0.5%) after a mean interval of 6.7 months. Serial HbA1c determination showed sustained reduction up to six months (7.1±0.5%, n=58), 7-12 months (7.2±1.2%, n=55), 13-24 months (6.8±0.5%, n=66), 25-36 months (6.8±0.8%, n=35), 37-48 months (6.8±0.7%, n=19), and 49-60 months (6.9±0.8%, n=12). Further extension of follow-up of more than five years (61-110 months) showed sustainability of glycemic control (6.6%, n=17), demonstrating a 32% HbA1c reduction from baseline. Significant weight gain after six months of follow-up persisting up to four years was observed. No hypoglycemic episodes were observed among patients who complied with automatic snacking.Conclusion: In our Filipino type 2 diabetic subjects, the use of combination pre-mixed human insulin plus insulin analog showed sustainability of glycemic control (9.7% vs. 6.6%) for a remarkable period of more than five years in 17 (12.3%) of the patient population.
