Exact(1)
Similarly, among patients using OADs in combination with insulin, glycemic control appeared to be greater among patients receiving prandial insulin alone, basal insulin alone, or insulin premixes compared with basal-bolus therapy, a more intensive intervention.
Similar(59)
Weight gain averaged 2.42 kg in the premix group compared with 1.44 kg in the basal group (between-groups difference of 1.0 kg [range 0.28 1.73], P = 0.01).
Factors influencing the choice of premix insulin compared with basal insulin alone, in the four-regions-combined (excluding Japan), were physician specialty, practice location and type and sex of physician, and participant region, baseline HbA1c and prior insulin secretagogue therapy (figure 1A).
Aside from the convenience for the patient, studies that compared the clinical effect gained by uses of premix insulin analog compared with premix human insulin have somewhat conflicting results.
However, treatment with premix insulin analogs, compared with basal analogs, used two instead of one injection per day.
The meta-analysis concluded that patients treated with premix insulin analog compared with basal-bolus regimen had a lower chance of reaching the HbA1c goal: 50.8 vs. 63.5% (odds ratio 0.57 [95% CI 0.36 0.9], P = 0.034), while there was no evidence of difference in incidence of hypoglycemia and weight gain between the two regimens.
Several meta-analyses combined the results of some of these studies (24– 27), Qayyum et al. (24) concluded that premix insulin analogs provided better postprandial glucose than premixed human insulin, while Davidson et al. (27) concluded that premix insulin analogs provided significant reduction in major hypoglycemic events compared with premix human insulin (0.45 [95% CI 0.22 0.93], P < 0.05).
In insulin-naïve patients with type 2 diabetes, glargine treatment combined with OADs is associated with significantly lower HbA1c levels and fewer episodes of symptomatic hypoglycaemia compared with premix [ 13].
However, the relative risk of overall and nocturnal hypoglycaemia was lower (p = 0.010 to p < 0.001) with basal or basal + mealtime compared with premix insulin, and for nocturnal (p = 0.021) but not overall hypoglycaemia for basal compared to basal + mealtime insulin.
The reduction in EINOx and EICO at optimum partial premixing (ΦF ≈ 3), as compared with that for the non-premixed swirling flame is at least 23%and77%7%, respectively.
Finally, though the human insulin premixes and insulin analog premixes exhibit the same number of minor hypoglycemic events (approximately 60%), the insulin analog premixes have been reported to reduce the risk of major hypoglycemic events compared with premixed human insulin.
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