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Clinical evaluation of thrice-daily lispro 50/50 versus twice-daily aspart 70/30 on blood glucose fluctuation and postprandial hyperglycemia in patients with type 2 diabetes mellitus

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Abstract

Aim

Our goal was to compare the effects of thrice-daily lispro 50/50 and twice-daily aspart 70/30 on blood glucose fluctuation and postprandial hyperglycemia in type 2 diabetes mellitus patients.

Methods

Thirty-nine type 2 diabetes patients hospitalized at our hospital for poorly controlled disease (26 men, 13 women; mean age 62.5 years, mean BMI 24.1) received either thrice-daily lispro 50/50 (50/50 group, n = 19) or twice-daily aspart 70/30 (70/30 group, n = 20) after 1 week of multiple-daily injection insulin regimen. Efficacy measurements included HbA1c, diurnal variation in blood glucose levels and total daily insulin doses. Despite a small number of subjects, we also explored the potent effect in prevention of progression of atherosclerosis. Ultrasound examination of bilateral carotid arteries (n = 22) and the cardio-ankle vascular index (CAVI) (n = 12) were performed before and after 48 weeks of treatment.

Results

Mean HbA1c levels improved significantly in each treatment group, and HbA1c at 48 weeks was significantly lower in the 50/50 group than the 70/30 group (7.0 ± 1.0 vs. 7.3 ± 1.1 %, P = 0.03), whereas mean fasting blood glucose levels did not differ significantly between the two groups at 48 weeks (127.4 ± 30.9 vs. 132.6 ± 20.6 mg/dL, P = 0.47). A significantly greater percentage of subjects in the 50/50 group achieved the target HbA1c value of ≤ 6.9 %compared to the 70/30 group [57.9 % (11/19 patients) vs. 25.0 % (5/20 patients), P = 0.01). The 50/50 group tended to have less daily plasma glucose fluctuation than the 70/30 group. Although there was a significant difference in the degrees of change in CAVI between the subsets of each group, there were no significant differences in the maximum thickness of the intima-media layers of the carotid arteries (IMT) and plaque scores.

Conclusions

Thrice-daily lispro 50/50 injection reduces the postprandial blood glucose level and stabilizes the diurnal fluctuations of blood glucose levels more efficiently than twice-daily aspart 70/30 in type 2 diabetes mellitus patients.

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Acknowledgments

The work herein was done at the Department of Endocrinology and Metabolism at Tonami General Hospital. The author wishes to thank the patients, investigators and their staff for participating in the study.

Conflict of interest

The author has no conflicts of interest to disclose.

Human rights statement and informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. Informed consent or a substitute for it was obtained from all patients for being included in the study.

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Authors and Affiliations

  1. Department of Endocrinology and Metabolism, Public Central Hospital of Matto Ishikawa, 3-8 Kuramitsu, Hakusan, Ishikawa, 924-8588, Japan

    Hiroshi Akahori

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  1. Hiroshi Akahori
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Correspondence to Hiroshi Akahori.

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Akahori, H. Clinical evaluation of thrice-daily lispro 50/50 versus twice-daily aspart 70/30 on blood glucose fluctuation and postprandial hyperglycemia in patients with type 2 diabetes mellitus. Diabetol Int 6, 275–283 (2015). https://doi.org/10.1007/s13340-014-0196-5

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  • DOI: https://doi.org/10.1007/s13340-014-0196-5

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