Glycemic control with different premixed insulin in Taiwanese people with type two diabetes mellitus

The aim of this study is to compare the clinical responses between Mixtard 50 HM (premixed insulin with 50% regular insulin (RI) and 50% neutral protamine Hagedom (NPH)) and Mixtard 30 HM (premixed insulin with 30% RI and 70% NPH) among type 2 diabetic patients. The acceptability of NovoPen 3 and traditional syringe was also evaluated among these patients.

Twenty-six patients were injected with Mixtard 30 HM initially using traditional syringe, which was switched to Mixtard 50 HM eight weeks later. When the switch commenced, patients were randomly assigned to two groups. One group used traditional syringe and the other used NovoPen 3. Blood glucoses were measured before breakfast, before lunch and at bedtime for two days in a week by patients themselves. Hemoglobin A(1c)(HbA(1c)) was checked at week 8 and week 16. At the end of the trial, patients completed 1 questionnaires regarding their acceptability of NovoPen 3.

There was no statistical difference in mean blood glucose levels measured before breakfast, before lunch, or at bedtime, or in HbA(1c), between Mixtard 30 HM and Mixtard 50 HM treatment periods. However, blood glucose after breakfast declined more in Mixtard 50 HM treatment period than in Mixtard 30 HM treatment period. Up to 96.2% of the study subjects reported that NovoPen 3 was more convenient in use than traditional syringe.

Blood glucose declined more from pre-breakfast level to pre-lunch level when patients used Mixtard 50 HM instead of Mixtard 30 HM. We suggest that Mixtard 50 HM is more appropriate for post-breakfast hyperglycemic diabetic patients. NovoPen 3 results in a similar clinical glycemic response but is better accepted by the patients than conventional syringe.