Premixed Insulin Increases Hypoglycemia in Inpatients With Diabetes

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Premixed Insulin Increases Hypoglycemia in Inpatients With Diabetes
Premixed Insulin Increases Hypoglycemia in Inpatients With Diabetes

(HealthDay News) — For hospitalized patients with diabetes, treatment with premixed insulin results in similar glycemic control but higher frequency of hypoglycemia compared with a basal-bolus regimen, according to a study published in Diabetes Care.

Virginia Bellido, from Hospital Universitario Central de Asturias in Spain, and colleagues conducted a prospective, open-label trial in which inpatients with diabetes were randomly assigned to receive a basal-bolus regimen with glargine once daily and glulisine before meals (n=33) or premixed human insulin twice daily (30% regular insulin, 70% NPH insulin; n=39).

The study was stopped prematurely at the first prespecified interim analysis because of an increased frequency of hypoglycemia in more than 50% in patients treated with premixed human insulin. Results showed that 64% and 24% of patients treated with premixed insulin and a basal-bolus regimen, respectively, experienced at least one of hypoglycemia (P<.001). 

After the first day of treatment, there were no differences seen in mean daily blood glucose level between the groups. In 55.9% of blood glucose readings in the basal-bolus group and 54.3% in the premixed insulin group, a blood glucose target between 80 mg/dL and 180 mg/dL before meals was achieved (P=.23).

"Inpatient treatment with premixed human insulin resulted in similar glycemic control but in significantly higher frequency of hypoglycemia compared with treatment with basal-bolus insulin regimen in hospitalized patients with diabetes," the researchers wrote.

Several researchers disclosed financial ties to pharmaceutical companies, including Sanofi-Aventis, which funded the study.

Reference

  1. Bellido V, Suarez L, Rodriguez MG, et al. Comparison of Basal-Bolus and Premixed Insulin Regimens in Hospitalized Patients With Type 2 Diabetes. Diabetes Care. 2015;doi:10.2337/dc15-0160.
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