Need stable diabetics mix their insulins?

Area of Science:

• Endocrinology
• Metabolic Diseases
• Pharmacology

Background:

• Insulin therapy is crucial for managing type 1 diabetes.
• Twice-daily insulin mixtures of soluble and isophane insulin are commonly prescribed.
• Patient self-mixing of insulin can introduce variability.

Purpose of the Study:

• To evaluate the glycaemic control using fixed-mixture insulin preparations.
• To compare fixed-mixtures with patient-prepared and pharmacy-prepared insulin regimens.
• To assess the efficacy of pre-mixed insulin in diabetic management.

Main Methods:

• Double-blind crossover trial involving ten insulin-dependent diabetics.
• Comparison of three insulin regimens: patient-mixed, pharmacy-mixed, and fixed-mixture preparations.
• Assessment of glycaemic control through daily blood glucose monitoring and modified log 'M' indices.

Main Results:

• Mean blood glucose levels were similar across all three regimens: 7.6 mmol/l (usual), 7.8 mmol/l (fixed-mixture), and 8.0 mmol/l (patient-mixed).
• Modified log 'M' indices also showed comparable glycaemic control: 1.26 (usual), 1.29 (fixed-mixture), and 1.37 (patient-mixed).
• No significant difference in glycaemic control was observed between fixed-mixture and traditional insulin regimens.

Conclusions:

• Fixed-mixture insulin preparations provide equivalent glycaemic control to 'tailormade' insulin regimens.
• Pre-mixed insulin can simplify diabetes management without compromising blood glucose control.
• This suggests fixed-mixtures are a viable alternative for insulin-dependent diabetics.