Designer insulins regimens in clinical practice--pilot multicenter Indian study

Area of Science:

• Endocrinology
• Pharmacology
• Diabetes Management

Background:

• Newer insulin analogues, such as premix biphasic insulin aspart and insulin glargine, are now accessible in India.
• A multicenter study was conducted to evaluate patient profiles and responses to these insulin analogues in real-world clinical settings.

Purpose of the Study:

• To document the patient profile and treatment responses to premix insulin analogue and basal-bolus analogue regimens in type-2 diabetes patients in India.
• To compare the efficacy and safety of these two insulin regimens in routine clinical practice.

Main Methods:

• A prospective study involving 145 type-2 diabetes patients across 4 Indian clinics.
• Patients received either twice-daily premix insulin analogue or a basal-bolus analogue regimen (insulin aspart with meals, insulin glargine at bedtime).
• Data on fasting plasma glucose (FPG), postprandial plasma glucose (PPPG), HbA1c, and insulin dose were collected at baseline, 4 weeks, and 12 weeks.

Main Results:

• Both insulin regimens significantly reduced blood glucose parameters, including HbA1c, compared to baseline.
• Premix insulin analogue showed a greater reduction in HbA1c (1.58% vs. 1.16%) and higher achievement of target HbA1c (<7%) compared to basal-bolus.
• The premix group required a lower mean insulin dose and experienced fewer minor hypoglycaemic episodes.

Conclusions:

• Twice-daily premix analogue and basal-bolus analogue regimens are convenient, safe, and effective for initiating insulin therapy in type-2 diabetes.
• Premix analogues offer better HbA1c control and compliance compared to basal-bolus regimens.
• Both regimens were well-tolerated with no major hypoglycaemias or adverse drug reactions reported.