Use of 50/50 Premixed Insulin Analogs in Type 2 Diabetes: Systematic Review and Clinical Recommendations

Deed, Gary; Kilov, Gary; Dunning, Trisha; Cutfield, Richard; Overland, Jane; Wu, Ted

doi:10.1007/s13300-017-0328-6

Cited by 8 publications

(4 citation statements)

References 49 publications

(168 reference statements)

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“…The prevalence of diabetes and prescription patterns of glucose-lowering agents differs across countries. For example, the most preferred treatment routine is basal-bolus in Australia but pre-mixed insulin in Saudi Arabia [ 14 , 15 ]. Consequently, it is important to ascertain the clinical parameters associated with the use of IDegAsp in diverse geographical settings.…”

Section: Rationalementioning

confidence: 99%

ARISE—a prospective, non-interventional, single-arm study assessing clinical parameters associated with the use of insulin degludec/insulin aspart in patients with type 2 diabetes in real-world settings: rationale and design

et al. 2021

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Purpose IDegAsp, a co-formulation of long-acting basal (insulin degludec) and rapid-acting bolus (insulin aspart) insulin, provides separate prandial and basal glucose-lowering effects with relatively low risk of hypoglycaemia. Its efficacy and safety have been investigated in a large clinical trial programme (BOOST). We present the rationale and design of the ARISE study, which aims to assess glycaemic control and other clinical parameters associated with IDegAsp use in real world. Methods ARISE is a ~26-wk-long, prospective, non-interventional, single-arm study of patients with type 2 diabetes (T2D) initiating IDegAsp treatment. Approximately 1112 patients with T2D aged ≥18 years previously on anti-hyperglycaemic drugs except IDegAsp will be enroled across six countries from 15 Aug 2019 to 12 Nov 2020. IDegAsp treatment will be initiated at the physicians’ discretion and as per the local label. Key exclusion criteria include previous participation, or previous IDegAsp treatment. The primary and secondary endpoints are change in HbA1c from baseline (wk 0) to study end (wk 26–36) and the proportion of patients achieving the target HbA1c level of <7% at the study end, respectively. A mixed model for repeated measurements will analyse the primary endpoint. Conclusion Between-country differences in the prescription patterns of glucose-lowering agents in people with T2D warrant examination of their clinical use in different geographical settings. The ARISE study is designed to assess the clinical use of IDegAsp from real world in six different countries. Findings from the ARISE study will supplement those of previous randomised controlled studies by establishing real-world evidence of IDegAsp use in the participating countries. Trial registration ClinicalTrials.gov, NCT04042441. Registered 02 August 2014, https://clinicaltrials.gov/ct2/show/NCT04042441

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Section: Rationalementioning

confidence: 99%

ARISE—a prospective, non-interventional, single-arm study assessing clinical parameters associated with the use of insulin degludec/insulin aspart in patients with type 2 diabetes in real-world settings: rationale and design

et al. 2021

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“…A randomized study performed by Chen et al showed that insulin mixtures containing 50% of the fast-acting analogue are much more effective in treating patients using higher carbohydrate diets [62]. This is reflected in the summary of clinical recommendations on the use of insulin mixtures in the treatment of type 2 diabetes, indicating that in some patients Mix50 mixtures may be more appropriate than Mix25/30 mixtures, and clinicians should consider not only efficacy and safety, but also traits and patient preferences during insulin treatment of people with type 2 diabetes [63].…”

Section: Insulin Therapy In People With Type 2 Diabetesmentioning

confidence: 99%

Insulin in Type 1 and Type 2 Diabetes—Should the Dose of Insulin Before a Meal be Based on Glycemia or Meal Content?

Krzymień

Ładyżyński

2019

Nutrients

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The aim of this review was to investigate existing guidelines and scientific evidence on determining insulin dosage in people with type 1 and type 2 diabetes, and in particular to check whether the prandial insulin dose should be calculated based on glycemia or the meal composition, including the carbohydrates, protein and fat content in a meal. By exploring the effect of the meal composition on postprandial glycemia we demonstrated that several factors may influence the increase in glycemia after the meal, which creates significant practical difficulties in determining the appropriate prandial insulin dose. Then we reviewed effects of the existing insulin therapy regimens on glycemic control. We demonstrated that in most existing algorithms aimed at calculating prandial insulin doses in type 1 diabetes only carbohydrates are counted, whereas in type 2 diabetes the meal content is often not taken into consideration. We conclude that prandial insulin doses in treatment of people with diabetes should take into account the pre-meal glycemia as well as the size and composition of meals. However, there are still open questions regarding the optimal way to adjust a prandial insulin dose to a meal and the possible benefits for people with type 1 and type 2 diabetes if particular parameters of the meal are taken into account while calculating the prandial insulin dose. The answers to these questions may vary depending on the type of diabetes.

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“…They should also be asked for preference regarding injection frequency and blood glucose monitoring. In addition, costs should be discussed to make the therapy affordable in the long term [ 33 ]. Continuous support and guidance from the treating physician can help combat patient fears and doubts and reduce the possibility of ‘psychological insulin resistance’ [ 34 , 35 ].…”

Section: Factors Influencing Choice Of Premixed Formulationsmentioning

confidence: 99%

Expert Opinion: Patient Selection for Premixed Insulin Formulations in Diabetes Care

et al. 2018

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Premixed insulins are an important tool for glycemic control in persons with diabetes. Equally important in diabetes care is the selection of the most appropriate insulin regimen for a particular individual at a specific time. Currently, the choice of insulin regimens for initiation or intensification of therapy is a subjective decision. In this article, we share insights, which will help in rational and objective selection of premixed formulations for initiation and intensification of insulin therapy. The glycemic status and its variations in a person help to identify the most appropriate insulin regimen and formulation for him or her. The evolution of objective glucometric indices has enabled better glycemic monitoring of individuals with diabetes. Management of diabetes has evolved from a ‘glucocentric’ approach to a ‘patient-centered’ approach; patient characteristics, needs, and preferences should be evaluated when considering premixed insulin for treatment of diabetes.Funding: Novo Nordisk, India.

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Use of 50/50 Premixed Insulin Analogs in Type 2 Diabetes: Systematic Review and Clinical Recommendations

Cited by 8 publications

References 49 publications

ARISE—a prospective, non-interventional, single-arm study assessing clinical parameters associated with the use of insulin degludec/insulin aspart in patients with type 2 diabetes in real-world settings: rationale and design

ARISE—a prospective, non-interventional, single-arm study assessing clinical parameters associated with the use of insulin degludec/insulin aspart in patients with type 2 diabetes in real-world settings: rationale and design

Insulin in Type 1 and Type 2 Diabetes—Should the Dose of Insulin Before a Meal be Based on Glycemia or Meal Content?

Expert Opinion: Patient Selection for Premixed Insulin Formulations in Diabetes Care

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