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Premixed Insulin Ups Hypoglycemia in Inpatients

Similar glycemic control as basal-bolus regimen but elevated frequency of hypoglycemia

THURSDAY, Oct. 15, 2015 (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 online Oct. 12 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 randomized to receive a basal-bolus regimen with glargine once daily and glulisine before meals (33 patients) or premixed human insulin twice daily (30 percent regular insulin, 70 percent NPH insulin; 39 patients).

The study was stopped prematurely at the first prespecified interim analysis because of an increased frequency of hypoglycemia >50 percent in patients treated with premixed human insulin. The researchers found that 64 and 24 percent of patients treated with premixed insulin and a basal-bolus regimen, respectively, experienced one or more episodes of hypoglycemia (P < 0.001). After the first day of treatment, there were no differences seen in mean daily blood glucose level between the groups. In 55.9 percent of blood glucose readings in the basal-bolus group and 54.3 percent in the premixed insulin group, a blood glucose target between 80 and 180 mg/dL before meals was achieved (P = 0.23).

“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 authors write.

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

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