Insulin analogs combined with oral antidiabetic drugs in treating patients with type 2 diabetes mellitus

Abstract:

Objective：To evaluate the efficacy and safety of insulin analogs（Insulin detemir，Insulin glargine，Biphasic insulin aspart 30） combined with oral antidiabetic drugs（OADs） in treating type 2 diabetic mellitus patients whose blood glucose is insufficiently con－trolled. Methods：Seventy-three type 2 diabetic mellitus patients with insufficiently controlled blood glucose were assigned to three groups：group treated with Insulin detemir once daily before bedtime（Insulin detemir group，n=23），group treated with Insulin glargine once daily before bedtime（Insulin glargine group，n=27），group treated with Biphasic insulin aspart 30 twice daily before breakfast and dinner（BIAsp30 group，n=23）. All patients were treated with OADs for 16 weeks. Hemoglobin A1c（HbA1c），fasting blood glucose（FBG），body mass index（BMI） were measured pre-treatment and after-treatment. Reductions of HbA1c，FBG and postprandial blood glucose（PBG），compliance rates of HbA1c（<7%） and incidences of hypoglycemia were compared. Results：There was no significant differences among three groups in HbA1c，FBG and PBG levels before the therapy. At the end of 16 weeks，HbA1c，FBG，PBG were decreased significantly in three groups（P<0.01），and there was no difference in reduction of HbA1c，FBG，PBG among three groups（P >0.05）. BMI did not change significantly pre-treatment and after-treatment in all groups. Compliance rates of HbA1c < 7% were 43%，59%，52% in Insulin detemir group，Insulin glargine group and BIAsp 30 group respectively. There was no difference in compliance rate of HbA1c<7% among three groups（P >0.05）. 3 patients（13%），2 patients（7%），5 patients（22%） had mild hypoglycemia in three groups respectively，but the incidence of hypoglycemia was not significantly different among three groups（P >0.05）. No severe hypo－glycemia happened in all groups. Conclusions：Effective control of FBG is important in decreasing HbA1c for type 2 diabetic mellitus patients whose blood glucose is insufficiently controlled. All three kinds of insulin analogs combined with OADs can decrease blood glucose without weight gain and hypoglycemia episode increase.