Page 570 - fbkCardioDiabetes_2017

546 Initiation & Intensification of Insulin Therapy in T2DM

4T Study : Relative Changes over 3

Years
Mean± 1SD
20 8
Biphasic insulin ± prandial 6
Prandial insulin ± basal
10
Mean relative change (%) -10 Events/Patient/Yr of 4
Basal insulin ± prandial
0

-20
2
-30
-40 No. 0
Glycated Fasting Postprandial Body Hypoglycaemia
Haemoglobin Plasma Glucose Weight Grade 2 or 3
Glucose
Baseline 8.5% 9.6 mmol/l 12.6 mmol/l 85.8 kg
value 173 mg/dl 227 mg/dl 188 lbs
p value 0.28 0.83 <0.001 0.20 <0.001

Basal-bolus regimen with insulin glargine is more
effective than twice-daily premixed insulin lispro

HbA 1c
Premixed insulin ▪
Basal-bolus lispro 50/50 Hypoglycaemia rates and
0 weight gain were similar in
the two groups
(%) ▪ premixed insulin group
Change from baseline –0.5 –2.1 –1.9 at dinner to achieve the FBG
55% of patients in the
–1.0
switched from premixed
insulin lispro 50/50 to 25/75
–1.5
target
-2.0
-2.5
p<0.021 for 0.2% difference
Basal-bolus insulin therapy provided a better efficacy
profile
and a similar safety profile
Rosenstock J, et al. Diabetes Care 2008;31:20–5.
Rosenstock J, et al. Diabetes Care 2007;31:20–5.

GCDC 2017