Clinical use and efficacy of biphasic insulin lispro 50/50 in people with insulin treated diabetes – a nationwide evaluation of clinical practice. (March 2015)

• Record Type: Journal Article
• Authors: Mungreiphy, N.K.; Mamza, J.; Lakhdar, A.F.; Bannister, M.; Elliott, J.; Idris, I.
• Is Part Of: Current medical research and opinion. Volume 31:Number 3(2015:Mar.)
• Page Start: 493
• Page End: 501
• Publication Date: 2015-03
• Subjects: Clinical medicine -- Periodicals; Therapeutics -- Periodicals; 615.5
• DOI: 10.1185/03007995.2015.1008689
• Languages: English
• ISSNs: 0300-7995

Abstract

<abstract> <title>Abstract</title> <sec id="ss1"> <title>Objectives:</title> <p>This study aims to investigate the metabolic effects of biphasic insulin lispro 50/50 in routine clinical practice. A total of 229 patients who were ≥18 years old with diabetes, newly treated with biphasic insulin lispro 50/50, were sourced from six secondary care services in England.</p> </sec> <sec id="ss2"> <title>Methods:</title> <p>Detailed clinical parameters were compared at baseline, and 3 and 6 months post-initiation. Responders was defined as those with HbA1c <7.5% (58 mmol/mol) and/or an HbA1c reduction of >1% (11 mmol/mol) at 6 months.</p> </sec> <sec id="ss3"> <title>Results:</title> <p>HbA1c showed significant reduction: −0.93% (−10 mmol/mol) and −1.2% (−13 mmol/mol) at 3 and 6 months respectively, while no significant change was noted for all the other parameters. When analyzed according to frequencies of injections/day, the greatest reduction was observed with the three times a day regimen (−1.0% [−11.0 mmol/mol] and −1.3% [−14.6 mmol/mol] at 3 and 6 months respectively). HbA1c reduction was greatest in the group who previously received a basal–bolus insulin regimen: (−0.8% [−9.0 mmol/mol] and −1.5% [−16.2 mmol/mol] at 3 and 6 months respectively). Reduction in weight was observed at 3 months (−1.8 kg ± 4.3) only for those who were previously on a basal–bolus insulin regimen. Insulin doses increased following conversion to biphasic insulin lispro 50/50, irrespective of the types of insulin used prior to biphasic insulin lispro 50/50, but this was not associated with weight gain. The independent predictors of response to biphasic insulin lispro 50/50 were baseline HbA1c, Caucasian, presence of nephropathy, prior use of basal–bolus insulin and prior use of other premixed combination.</p> </sec> <sec id="ss4"> <title>Conclusion:</title> <p>Biphasic insulin lispro 50/50 is therefore an effective therapeutic option for achieving glycemic control in patients with suboptimal HbA1c levels, especially among those who were previously on a basal–bolus insulin regimen and those who received it three times daily, with a neutral effect on weight parameters.</p> </sec> <sec id="ss5"> <title>Limitations:</title> <p>This was a retrospective study of routine clinical practice and is therefore limited by allocation bias and some missing data. Information on rates of hypoglycemia and quality of life are not available.</p> </sec> </abstract>