Premixed insulin analogues reduced fasting glucose, HbA1c levels

Compared with long-acting insulin analogues and noninsulin anti-diabetic agents, premixed insulin analogues may offer tighter glycemic control to patients with type 2 diabetes.

According to researchers from John Hopkins University in Baltimore, premixed insulin analogues may be as effective as premixed human insulin in lowering fasting glucose and HbA1c levels. The researchers conducted a systematic review to assess intermediate outcomes of premixed insulin analogues vs. other antidiabetic medications.

The researchers reported that premixed insulin analogues provided decreases similar to premixed human insulin in fasting glucose and HbA1c levels, though the analogues were most effective in reducing levels of postprandial glucose (mean difference = –1.1 mmol/L; 95% CI, –1.4 to –0.7 mmol/L).

Premixed insulin analogues were associated with a higher incidence of hypoglycemia and were less effective than long-acting insulin analogues in reducing fasting glucose levels (mean difference = 0.7 mmol/L; 95% CI, 0.3-1.0). However, premixed insulin analogues were superior in reducing postprandial glucose (mean difference = –1.5 mmol/L; 95% CI, –1.9 to –1.2) and HbA1c levels (mean difference = –0.39%; 95% CI, –0.50% to –0.28%).

Similarly, compared with non-insulin anti-diabetic agents, premixed insulin analogues were associated with a higher incidence of hypoglycemia but were superior in reducing fasting glucose, postprandial glucose and HbA1c levels.

Ann Intern Med. 2008;149:1-12.