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| Topic: |
diabetes (dm) |
| Title: |
Choosing an Insulin Regimen for Patients With Type 2 Diabetes. |
| Author: |
Pignone, M. |
| Source: |
Clinical Diabetes. 26(2): 63-64. Winter 2008. |
| Abstract: |
This article reports on a randomized, controlled study undertaken to compare three insulin regimens used for patients with type 2 diabetes: biphasic insulin aspart twice daily, prandial insulin aspart three times daily, or basal insulin detemir once daily—with the option of using twice daily if needed. Participants were 708 adult patients (64 percent male), with a mean age of 61.7 years, with type 2 diabetes, glycosylated hemoglobin (A1C) levels between 7 and 10 percent on oral hypoglycemic drugs, and a willingness and ability to inject insulin and perform self-monitoring of blood glucose (SMBG). Patients were recruited from 58 clinical centers in the United Kingdom and Ireland. After 52 weeks, the mean A1C was 7.3 percent for the biphasic insulin group; 7.2 percent for the group on prandial insulin; and 7.6 percent for basal insulin. Few patients achieved an A1C of less than 6.5 percent. Hypoglycemia was experienced more in the biphasic and prandial groups than in the basal insulin group; no severe hypoglycemia occurred. This article summarizes these research results, referring readers to the original publication of the study (Holman et al., New England Journal of Medicine, volume 357, 2007). The author provides a commentary about this study, supporting the work that helps clinicians determine appropriate insulin regimens for their patients with type 2 diabetes. The author cautions that the outcomes obtained in clinical care may differ from those achieved in the research setting, which included more structured patient assessment and follow-up. 2 references. |
| Format: |
Journal Article |
| Language: |
English. |
| Major Keywords: |
Diabetes Mellitus. Type 2 Diabetes. Insulin. Administration and Dosage. Insulin Aspart. Insulin Detemir. Patient Care Management. |
| Minor Keywords: |
Glycosylated Hemoglobin. Monitoring. SMBG. Hypoglycemia. Hyperglycemia. Drug Therapy. Drug Effects. Patient Selection. |
| Publication Number: |
DMJA13382 |
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