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.
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

Background : Physiologic pancreatic response to glucose load yields two peaks of insulin secretion: the first peak within 30 mins. , and the second to 3rd hour after the stimulus .Objective: Our aim to show that a combination therapy designed to mimic this insulin secretion obtains optimal glycemic control with sustainability Methods : in this descriptive retrospective study , we measured glycemic control and sustainability in terms of reduction in HbA1c and postprandial capillary blood glucose (pCBG) between patients on insulin 70/30 with lispro and insulin 70/30 alone . We reviewed records of 218 patients (153 females ; 65 males ) in outpatient endocrinology clinic . Initial and follow-up pCBG (2 to 4hours after lunch ) and HbA1c were measured and compared among study groups . Metformin 1000 to 1500 mg daily was given in combination with insulin .Conclusion: Combination insulin therapy with 70/30 and lispro mimicking physiologic insulin secretion yielded sustainability of glycemic in control (18% HbA1c reduction ) in type 2DM patients
Combination Insulin ; Lispro