Self-titration of biphasic insulin aspart 30/70 improves glycaemic control and allows easy intensification in a Dutch clinical practice

Abstract 

Aims

This 18-month study assessed the improvement in glycaemic control and proportion of patients reaching glycated haemoglobin (HbA_1c) targets with biphasic insulin aspart 30/70 (BIAsp 30) in clinical practice.

Methods

Type-2 diabetes patients failing on oral antidiabetic drugs (n=90) or existing insulin regimens (n=59) started or switched to BIAsp 30. Thiazolidinediones were stopped, metformin was continued. BIAsp 30 was given once daily (n=41), twice daily (n=96), or three times daily (n=12). Patients were taught self-monitoring and self-titration using an algorithm, adding daily doses of BIAsp 30 when necessary.

Results

Mean baseline HbA_1c was 8.4%, weight 85.4kg, and age 57.9 years. All patients experienced significant reductions in HbA_1c (mean 1.9%±0.1), fasting plasma glucose (mean 2.8mmol/l), and post-prandial glycaemia (mean 2.9mmol/l); 91% of patients achieved HbA_1c<7% and 52% achieved HbA_1c≤6.5%. No major or nocturnal hypoglycaemia were reported; 15% of patients reported minor hypoglycaemia. Insulin-naïve patients gained mean 2.7kg; patients who switched from another insulin lost weight (mean −0.6kg).

Conclusion

The results from this study from routine care suggest that BIAsp 30 may allow a large proportion of type-2 diabetes patients (90%) to improve glycaemic control and reach target HbA_1c<7%, using self-titration.

Keywords: Type-2 diabetes, Biphasic insulin aspart 30/70, Observational study