The optimal morning:evening ratio in total dose of twice-daily biphasic insulin analogue in poorly controlled Type 2 diabetes: a 24-week multi-centre prospective, randomized controlled, open-labelled clinical study
Aims Biphasic insulin analogues are widely used in patients with Type 2 diabetes mellitus suboptimally controlled on oral anti‐diabetic drugs. Several topics in this area remain controversial, including how to divide the daily dose of biphasic insulin analogue. We aimed to determine the optimal dosi...
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| Veröffentlicht in: | Diabetic medicine 2014-01, Vol.31 (1), p.68-75 |
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| creator | Jung, C. H. Park, J.-Y. Cho, J. H. Yoon, K.-H. Yang, H. K. Lee, Y.-H. Cha, B. S. Lee, B.-W. |
| description | Aims
Biphasic insulin analogues are widely used in patients with Type 2 diabetes mellitus suboptimally controlled on oral anti‐diabetic drugs. Several topics in this area remain controversial, including how to divide the daily dose of biphasic insulin analogue. We aimed to determine the optimal dosing ratio of twice‐daily biphasic insulin analogue and to compare the glycaemic efficacy among groups of patients using different initial dosing ratios of biphasic insulin analogue.
Methods
A total of 100 poorly controlled insulin‐naive subjects with Type 2 diabetes [HbA1c ≥ 58 mmol/mol, (7.5%)] on oral anti‐diabetic drugs were randomized into three groups according to initial morning:evening dosing ratio (group I, 50:50; group II, 55:45; group III, 60:40) of twice‐daily biphasic insulin analogue (biphasic insulin aspart 70/30, biphasic insulin aspart 30). The primary outcome measure was the difference in pre‐breakfast to pre‐dinner dose ratio at the end of the study.
Results
Twice‐daily biphasic insulin analogue showed a significant improvement in glycaemic control [HbA1c from 70 mmol/mol (8.6%) to 60 mmol/mol (7.6%)] after 24 weeks regardless of the initial dose ratio given. Despite the similar efficacy and safety profiles among three groups, morning dose was significantly increased (from 50:50 to 55:45–60:40) in group I after 24 weeks. However, there was no significant change in splitting ratio in groups II and III (with higher morning dose) over the 24‐week treatment period.
Conclusions
These results indicate that initiating twice‐daily biphasic insulin analogue on regimens with a higher dose before breakfast than before dinner (i.e. ratio approximately 55:45 to 60:40) might be more appropriate in Korean subjects with Type 2 diabetes.
What's new?
Although biphasic insulin analogues are widely used in patients with Type 2 diabetes who are suboptimally controlled on oral anti‐diabetic drugs, the optimal dosing ratio of twice‐daily biphasic insulin analogue is currently unknown.
Currently, the pre‐breakfast:pre‐dinner ratio of 50:50 is recommended by several clinical guidelines. However, there is a lack of evidence for these starting regimens regarding the dosing split before breakfast and before dinner.
This study is, to our best knowledge, the first randomized study that has investigated the optimal dosing ratio of twice‐daily biphasic insulin analogue. |
| doi_str_mv | 10.1111/dme.12322 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1477557617</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3154585121</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4212-76c693fec85c5e3c8bedab6c89bc130857c33e3e799e3f5550b0a190340ed2dc3</originalsourceid><addsrcrecordid>eNp1kd1O1UAUhRujEUQvfAEziSHRhML8dDotd4IIJqAxOcrlZDrdhYG2UztTjsen8Vl8CV_HfTgHSEycm30x3157Za0kecnoLsO3V3ewy7jg_FGyybI8S2VWssfJJlUZTwVVbCN5FsIVpYyXonyabPCMsYIxsZn8mV0C8UN0nWlJ58fe9Rf7cAPLSUYTnSeuJ9FH_K59QLYhce4spLVx7YJUbrg0wVmkwtQianrT-osJlmuD9yMy1vdx9G0LNZktBvj9i5PamQoihH1iCM_SOcA16aY2utQCwkCG0YcBbHQ3sIM--tp37icKPGjtoG3o0xaFbqUtXncWbYY41YvnyZPGtAFerOdW8vXD0ezwJD39fPzx8N1pajPOeKpym5eiAVtIK0HYooLaVLktysoyQQuprBAgQJUliEZKSStqWElFRqHmtRVbyZuVLhr-PkGIunPBoiPTg5-CZplSUqqcKURf_4Ne-WnEuJZUrqRShaJIvV1RFhMIIzR6GLGccaEZ1cu2Nbatb9tG9tVacao6qO_Ju3oR2F4DJmA0DQZpXXjgCppRTgvk9lbc3LWw-P9F_f7s6O50utpwIcKP-w0zXutcCSX1-adj_eXkgJ_Pzr7pA_EXARjU0g</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1467577870</pqid></control><display><type>article</type><title>The optimal morning:evening ratio in total dose of twice-daily biphasic insulin analogue in poorly controlled Type 2 diabetes: a 24-week multi-centre prospective, randomized controlled, open-labelled clinical study</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Jung, C. H. ; Park, J.-Y. ; Cho, J. H. ; Yoon, K.-H. ; Yang, H. K. ; Lee, Y.-H. ; Cha, B. S. ; Lee, B.-W.</creator><creatorcontrib>Jung, C. H. ; Park, J.-Y. ; Cho, J. H. ; Yoon, K.-H. ; Yang, H. K. ; Lee, Y.-H. ; Cha, B. S. ; Lee, B.-W.</creatorcontrib><description>Aims
Biphasic insulin analogues are widely used in patients with Type 2 diabetes mellitus suboptimally controlled on oral anti‐diabetic drugs. Several topics in this area remain controversial, including how to divide the daily dose of biphasic insulin analogue. We aimed to determine the optimal dosing ratio of twice‐daily biphasic insulin analogue and to compare the glycaemic efficacy among groups of patients using different initial dosing ratios of biphasic insulin analogue.
Methods
A total of 100 poorly controlled insulin‐naive subjects with Type 2 diabetes [HbA1c ≥ 58 mmol/mol, (7.5%)] on oral anti‐diabetic drugs were randomized into three groups according to initial morning:evening dosing ratio (group I, 50:50; group II, 55:45; group III, 60:40) of twice‐daily biphasic insulin analogue (biphasic insulin aspart 70/30, biphasic insulin aspart 30). The primary outcome measure was the difference in pre‐breakfast to pre‐dinner dose ratio at the end of the study.
Results
Twice‐daily biphasic insulin analogue showed a significant improvement in glycaemic control [HbA1c from 70 mmol/mol (8.6%) to 60 mmol/mol (7.6%)] after 24 weeks regardless of the initial dose ratio given. Despite the similar efficacy and safety profiles among three groups, morning dose was significantly increased (from 50:50 to 55:45–60:40) in group I after 24 weeks. However, there was no significant change in splitting ratio in groups II and III (with higher morning dose) over the 24‐week treatment period.
Conclusions
These results indicate that initiating twice‐daily biphasic insulin analogue on regimens with a higher dose before breakfast than before dinner (i.e. ratio approximately 55:45 to 60:40) might be more appropriate in Korean subjects with Type 2 diabetes.
What's new?
Although biphasic insulin analogues are widely used in patients with Type 2 diabetes who are suboptimally controlled on oral anti‐diabetic drugs, the optimal dosing ratio of twice‐daily biphasic insulin analogue is currently unknown.
Currently, the pre‐breakfast:pre‐dinner ratio of 50:50 is recommended by several clinical guidelines. However, there is a lack of evidence for these starting regimens regarding the dosing split before breakfast and before dinner.
This study is, to our best knowledge, the first randomized study that has investigated the optimal dosing ratio of twice‐daily biphasic insulin analogue.</description><identifier>ISSN: 0742-3071</identifier><identifier>EISSN: 1464-5491</identifier><identifier>DOI: 10.1111/dme.12322</identifier><identifier>PMID: 24118113</identifier><identifier>CODEN: DIMEEV</identifier><language>eng</language><publisher>Oxford: Blackwell Publishing Ltd</publisher><subject>Biological and medical sciences ; Biphasic Insulins - administration & dosage ; Biphasic Insulins - pharmacokinetics ; Blood Glucose - drug effects ; Blood Glucose - metabolism ; Blood Glucose Self-Monitoring ; Diabetes ; Diabetes Mellitus, Type 2 - drug therapy ; Diabetes Mellitus, Type 2 - metabolism ; Diabetes. Impaired glucose tolerance ; Dose-Response Relationship, Drug ; Drug Administration Schedule ; Drug dosages ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; Feeding. Feeding behavior ; Female ; Fundamental and applied biological sciences. Psychology ; Glycated Hemoglobin A - drug effects ; Glycated Hemoglobin A - metabolism ; Humans ; Hyperglycemia ; Hypoglycemic Agents - administration & dosage ; Hypoglycemic Agents - pharmacokinetics ; Male ; Medical sciences ; Middle Aged ; Prospective Studies ; Republic of Korea ; Time Factors ; Treatment Outcome ; Vertebrates: anatomy and physiology, studies on body, several organs or systems ; Vertebrates: endocrinology</subject><ispartof>Diabetic medicine, 2014-01, Vol.31 (1), p.68-75</ispartof><rights>2013 The Authors. Diabetic Medicine © 2013 Diabetes UK</rights><rights>2015 INIST-CNRS</rights><rights>2013 The Authors. Diabetic Medicine © 2013 Diabetes UK.</rights><rights>Diabetic Medicine © 2014 Diabetes UK</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4212-76c693fec85c5e3c8bedab6c89bc130857c33e3e799e3f5550b0a190340ed2dc3</citedby><cites>FETCH-LOGICAL-c4212-76c693fec85c5e3c8bedab6c89bc130857c33e3e799e3f5550b0a190340ed2dc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fdme.12322$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fdme.12322$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,4010,27900,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=28040208$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24118113$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jung, C. H.</creatorcontrib><creatorcontrib>Park, J.-Y.</creatorcontrib><creatorcontrib>Cho, J. H.</creatorcontrib><creatorcontrib>Yoon, K.-H.</creatorcontrib><creatorcontrib>Yang, H. K.</creatorcontrib><creatorcontrib>Lee, Y.-H.</creatorcontrib><creatorcontrib>Cha, B. S.</creatorcontrib><creatorcontrib>Lee, B.-W.</creatorcontrib><title>The optimal morning:evening ratio in total dose of twice-daily biphasic insulin analogue in poorly controlled Type 2 diabetes: a 24-week multi-centre prospective, randomized controlled, open-labelled clinical study</title><title>Diabetic medicine</title><addtitle>Diabet. Med</addtitle><description>Aims
Biphasic insulin analogues are widely used in patients with Type 2 diabetes mellitus suboptimally controlled on oral anti‐diabetic drugs. Several topics in this area remain controversial, including how to divide the daily dose of biphasic insulin analogue. We aimed to determine the optimal dosing ratio of twice‐daily biphasic insulin analogue and to compare the glycaemic efficacy among groups of patients using different initial dosing ratios of biphasic insulin analogue.
Methods
A total of 100 poorly controlled insulin‐naive subjects with Type 2 diabetes [HbA1c ≥ 58 mmol/mol, (7.5%)] on oral anti‐diabetic drugs were randomized into three groups according to initial morning:evening dosing ratio (group I, 50:50; group II, 55:45; group III, 60:40) of twice‐daily biphasic insulin analogue (biphasic insulin aspart 70/30, biphasic insulin aspart 30). The primary outcome measure was the difference in pre‐breakfast to pre‐dinner dose ratio at the end of the study.
Results
Twice‐daily biphasic insulin analogue showed a significant improvement in glycaemic control [HbA1c from 70 mmol/mol (8.6%) to 60 mmol/mol (7.6%)] after 24 weeks regardless of the initial dose ratio given. Despite the similar efficacy and safety profiles among three groups, morning dose was significantly increased (from 50:50 to 55:45–60:40) in group I after 24 weeks. However, there was no significant change in splitting ratio in groups II and III (with higher morning dose) over the 24‐week treatment period.
Conclusions
These results indicate that initiating twice‐daily biphasic insulin analogue on regimens with a higher dose before breakfast than before dinner (i.e. ratio approximately 55:45 to 60:40) might be more appropriate in Korean subjects with Type 2 diabetes.
What's new?
Although biphasic insulin analogues are widely used in patients with Type 2 diabetes who are suboptimally controlled on oral anti‐diabetic drugs, the optimal dosing ratio of twice‐daily biphasic insulin analogue is currently unknown.
Currently, the pre‐breakfast:pre‐dinner ratio of 50:50 is recommended by several clinical guidelines. However, there is a lack of evidence for these starting regimens regarding the dosing split before breakfast and before dinner.
This study is, to our best knowledge, the first randomized study that has investigated the optimal dosing ratio of twice‐daily biphasic insulin analogue.</description><subject>Biological and medical sciences</subject><subject>Biphasic Insulins - administration & dosage</subject><subject>Biphasic Insulins - pharmacokinetics</subject><subject>Blood Glucose - drug effects</subject><subject>Blood Glucose - metabolism</subject><subject>Blood Glucose Self-Monitoring</subject><subject>Diabetes</subject><subject>Diabetes Mellitus, Type 2 - drug therapy</subject><subject>Diabetes Mellitus, Type 2 - metabolism</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Dose-Response Relationship, Drug</subject><subject>Drug Administration Schedule</subject><subject>Drug dosages</subject><subject>Endocrine pancreas. Apud cells (diseases)</subject><subject>Endocrinopathies</subject><subject>Etiopathogenesis. Screening. Investigations. Target tissue resistance</subject><subject>Feeding. Feeding behavior</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Glycated Hemoglobin A - drug effects</subject><subject>Glycated Hemoglobin A - metabolism</subject><subject>Humans</subject><subject>Hyperglycemia</subject><subject>Hypoglycemic Agents - administration & dosage</subject><subject>Hypoglycemic Agents - pharmacokinetics</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Prospective Studies</subject><subject>Republic of Korea</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Vertebrates: anatomy and physiology, studies on body, several organs or systems</subject><subject>Vertebrates: endocrinology</subject><issn>0742-3071</issn><issn>1464-5491</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kd1O1UAUhRujEUQvfAEziSHRhML8dDotd4IIJqAxOcrlZDrdhYG2UztTjsen8Vl8CV_HfTgHSEycm30x3157Za0kecnoLsO3V3ewy7jg_FGyybI8S2VWssfJJlUZTwVVbCN5FsIVpYyXonyabPCMsYIxsZn8mV0C8UN0nWlJ58fe9Rf7cAPLSUYTnSeuJ9FH_K59QLYhce4spLVx7YJUbrg0wVmkwtQianrT-osJlmuD9yMy1vdx9G0LNZktBvj9i5PamQoihH1iCM_SOcA16aY2utQCwkCG0YcBbHQ3sIM--tp37icKPGjtoG3o0xaFbqUtXncWbYY41YvnyZPGtAFerOdW8vXD0ezwJD39fPzx8N1pajPOeKpym5eiAVtIK0HYooLaVLktysoyQQuprBAgQJUliEZKSStqWElFRqHmtRVbyZuVLhr-PkGIunPBoiPTg5-CZplSUqqcKURf_4Ne-WnEuJZUrqRShaJIvV1RFhMIIzR6GLGccaEZ1cu2Nbatb9tG9tVacao6qO_Ju3oR2F4DJmA0DQZpXXjgCppRTgvk9lbc3LWw-P9F_f7s6O50utpwIcKP-w0zXutcCSX1-adj_eXkgJ_Pzr7pA_EXARjU0g</recordid><startdate>201401</startdate><enddate>201401</enddate><creator>Jung, C. H.</creator><creator>Park, J.-Y.</creator><creator>Cho, J. H.</creator><creator>Yoon, K.-H.</creator><creator>Yang, H. K.</creator><creator>Lee, Y.-H.</creator><creator>Cha, B. S.</creator><creator>Lee, B.-W.</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope></search><sort><creationdate>201401</creationdate><title>The optimal morning:evening ratio in total dose of twice-daily biphasic insulin analogue in poorly controlled Type 2 diabetes: a 24-week multi-centre prospective, randomized controlled, open-labelled clinical study</title><author>Jung, C. H. ; Park, J.-Y. ; Cho, J. H. ; Yoon, K.-H. ; Yang, H. K. ; Lee, Y.-H. ; Cha, B. S. ; Lee, B.-W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4212-76c693fec85c5e3c8bedab6c89bc130857c33e3e799e3f5550b0a190340ed2dc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Biological and medical sciences</topic><topic>Biphasic Insulins - administration & dosage</topic><topic>Biphasic Insulins - pharmacokinetics</topic><topic>Blood Glucose - drug effects</topic><topic>Blood Glucose - metabolism</topic><topic>Blood Glucose Self-Monitoring</topic><topic>Diabetes</topic><topic>Diabetes Mellitus, Type 2 - drug therapy</topic><topic>Diabetes Mellitus, Type 2 - metabolism</topic><topic>Diabetes. Impaired glucose tolerance</topic><topic>Dose-Response Relationship, Drug</topic><topic>Drug Administration Schedule</topic><topic>Drug dosages</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>Etiopathogenesis. Screening. Investigations. Target tissue resistance</topic><topic>Feeding. Feeding behavior</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Glycated Hemoglobin A - drug effects</topic><topic>Glycated Hemoglobin A - metabolism</topic><topic>Humans</topic><topic>Hyperglycemia</topic><topic>Hypoglycemic Agents - administration & dosage</topic><topic>Hypoglycemic Agents - pharmacokinetics</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Prospective Studies</topic><topic>Republic of Korea</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Vertebrates: anatomy and physiology, studies on body, several organs or systems</topic><topic>Vertebrates: endocrinology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jung, C. H.</creatorcontrib><creatorcontrib>Park, J.-Y.</creatorcontrib><creatorcontrib>Cho, J. H.</creatorcontrib><creatorcontrib>Yoon, K.-H.</creatorcontrib><creatorcontrib>Yang, H. K.</creatorcontrib><creatorcontrib>Lee, Y.-H.</creatorcontrib><creatorcontrib>Cha, B. S.</creatorcontrib><creatorcontrib>Lee, B.-W.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetic medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jung, C. H.</au><au>Park, J.-Y.</au><au>Cho, J. H.</au><au>Yoon, K.-H.</au><au>Yang, H. K.</au><au>Lee, Y.-H.</au><au>Cha, B. S.</au><au>Lee, B.-W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The optimal morning:evening ratio in total dose of twice-daily biphasic insulin analogue in poorly controlled Type 2 diabetes: a 24-week multi-centre prospective, randomized controlled, open-labelled clinical study</atitle><jtitle>Diabetic medicine</jtitle><addtitle>Diabet. Med</addtitle><date>2014-01</date><risdate>2014</risdate><volume>31</volume><issue>1</issue><spage>68</spage><epage>75</epage><pages>68-75</pages><issn>0742-3071</issn><eissn>1464-5491</eissn><coden>DIMEEV</coden><abstract>Aims
Biphasic insulin analogues are widely used in patients with Type 2 diabetes mellitus suboptimally controlled on oral anti‐diabetic drugs. Several topics in this area remain controversial, including how to divide the daily dose of biphasic insulin analogue. We aimed to determine the optimal dosing ratio of twice‐daily biphasic insulin analogue and to compare the glycaemic efficacy among groups of patients using different initial dosing ratios of biphasic insulin analogue.
Methods
A total of 100 poorly controlled insulin‐naive subjects with Type 2 diabetes [HbA1c ≥ 58 mmol/mol, (7.5%)] on oral anti‐diabetic drugs were randomized into three groups according to initial morning:evening dosing ratio (group I, 50:50; group II, 55:45; group III, 60:40) of twice‐daily biphasic insulin analogue (biphasic insulin aspart 70/30, biphasic insulin aspart 30). The primary outcome measure was the difference in pre‐breakfast to pre‐dinner dose ratio at the end of the study.
Results
Twice‐daily biphasic insulin analogue showed a significant improvement in glycaemic control [HbA1c from 70 mmol/mol (8.6%) to 60 mmol/mol (7.6%)] after 24 weeks regardless of the initial dose ratio given. Despite the similar efficacy and safety profiles among three groups, morning dose was significantly increased (from 50:50 to 55:45–60:40) in group I after 24 weeks. However, there was no significant change in splitting ratio in groups II and III (with higher morning dose) over the 24‐week treatment period.
Conclusions
These results indicate that initiating twice‐daily biphasic insulin analogue on regimens with a higher dose before breakfast than before dinner (i.e. ratio approximately 55:45 to 60:40) might be more appropriate in Korean subjects with Type 2 diabetes.
What's new?
Although biphasic insulin analogues are widely used in patients with Type 2 diabetes who are suboptimally controlled on oral anti‐diabetic drugs, the optimal dosing ratio of twice‐daily biphasic insulin analogue is currently unknown.
Currently, the pre‐breakfast:pre‐dinner ratio of 50:50 is recommended by several clinical guidelines. However, there is a lack of evidence for these starting regimens regarding the dosing split before breakfast and before dinner.
This study is, to our best knowledge, the first randomized study that has investigated the optimal dosing ratio of twice‐daily biphasic insulin analogue.</abstract><cop>Oxford</cop><pub>Blackwell Publishing Ltd</pub><pmid>24118113</pmid><doi>10.1111/dme.12322</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | Diabetic medicine, 2014-01, Vol.31 (1), p.68-75 |
| issn | 0742-3071 1464-5491 |
| language | eng |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Biological and medical sciences Biphasic Insulins - administration & dosage Biphasic Insulins - pharmacokinetics Blood Glucose - drug effects Blood Glucose - metabolism Blood Glucose Self-Monitoring Diabetes Diabetes Mellitus, Type 2 - drug therapy Diabetes Mellitus, Type 2 - metabolism Diabetes. Impaired glucose tolerance Dose-Response Relationship, Drug Drug Administration Schedule Drug dosages Endocrine pancreas. Apud cells (diseases) Endocrinopathies Etiopathogenesis. Screening. Investigations. Target tissue resistance Feeding. Feeding behavior Female Fundamental and applied biological sciences. Psychology Glycated Hemoglobin A - drug effects Glycated Hemoglobin A - metabolism Humans Hyperglycemia Hypoglycemic Agents - administration & dosage Hypoglycemic Agents - pharmacokinetics Male Medical sciences Middle Aged Prospective Studies Republic of Korea Time Factors Treatment Outcome Vertebrates: anatomy and physiology, studies on body, several organs or systems Vertebrates: endocrinology |
| title | The optimal morning:evening ratio in total dose of twice-daily biphasic insulin analogue in poorly controlled Type 2 diabetes: a 24-week multi-centre prospective, randomized controlled, open-labelled clinical study |
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