The impact of the timing of Humalog Mix25 injections on blood glucose fluctuations in the postprandial period in elderly patients with type 2 diabetes.
Eduard Galic, Matjaz Vrtovec, Velimir Bozikov, Maria Schwarzenhofer, Zvonko Milicevic
Med Sci Monit 2005; 11(12): PI87-92
BACKGROUND: Postprandial hyperglycemia contributes to glycation of hemoglobin A1c and has been associated with cardiovascular risk in people with diabetes. We investigated the impact of injection timing of Humalog Mix25 (Mix25, known as Humalog Mix75/25 in the U.S.: 25% insulin lispro and 75% neutral protamine lispro) on glycemia and postprandial blood glucose (BG) excursions in elderly individuals MATERIAL/METHODS: Seventy-three patients aged 60 to 80 years were randomized to Mix25 (Mix25 group, 37 participants) or a continuation with maximum dose glibenclamide (control group, 36 participants). The Mix25 group was subdivided into a group of 18 patients who were injecting insulin after meals and 19 who were injecting before. RESULTS: At baseline, the absolute postprandial BG concentrations and postprandial BG excursions after breakfast were high (Mix25 group: 15.3+/-4.8 mmol/l and 3.5+/-2.7 mmol/l, respectively; controls: 15.4+/-3.9 mmol/l and 4.7+/-2.7 mmol/l, respectively). In both groups improvement was observed at the endpoint, but it was greater with Mix25 (Mix25 group: 10.3+/-3.6 mmol/l, p
Keywords: Humans, Postprandial Period - drug effects, Middle Aged, Male, Insulin, Isophane, Insulin Lispro, Insulin - therapeutic use, Hypoglycemic Agents - therapeutic use, Hypoglycemia - chemically induced, Blood Glucose - metabolism, Glyburide - administration & dosage, Female, Drug Administration Schedule, Diabetes Mellitus, Type 2 - metabolism, Body Weight - drug effects, Aged, Aged, 80 and over, Biphasic Insulins