Clinical experience with BIAsp 30: Results from the Indonesian cohort of the international A1chieve study

Soewondo, Pradana; Pramono, Raden Bowo; Langi, Yuanita A.; Soetedjo, Nanny Natalia Mulyani; Kshanti, Ida Ayu Made

doi:10.1016/s0168-8227(13)70011-1

Cited by 3 publications

(2 citation statements)

References 16 publications

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“…[ 57 58 59 60 ] An improvement in hypoglycemia with BIAsp 30 was also reported in this and other observational trials. [ 54 55 57 58 59 60 ]…”

Section: Discussionsupporting

confidence: 70%

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Efficacy and safety of biphasic insulin aspart and biphasic insulin lispro mix in patients with type 2 diabetes: A review of the literature

Kumar

2016

Indian J Endocr Metab

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Type 2 diabetes (T2D) represents an escalating burden worldwide, particularly in China and India. Compared with Caucasians, Asian people with diabetes have lower body mass index, increased visceral adiposity, and postprandial glucose (PPG)/insulin resistance. Since postprandial hyperglycemia contributes significantly to total glycemic burden and is associated with heightened cardiovascular risk, targeting PPG early in T2D is paramount. Premixed insulin regimens are widely used in Asia due to their convenience and effectiveness. Data from randomized controlled trials and observational studies comparing efficacy and safety of biphasic insulin aspart 30 (BIAsp 30) with biphasic insulin lispro mix (LM 25/50) and versus other insulin therapies or oral antidiabetic drugs (OADs) in T2D demonstrated that BIAsp 30 and LM 25/50 were associated with similar or greater improvements in glycemic control versus comparator regimens, such as basal–bolus insulin, in insulin-naÏve, and prior insulin users. Studies directly comparing BIAsp 30 and LM 25 provided conflicting glycemic control results. Safety data generally showed increased hypoglycemia and weight gain with premixed insulins versus basal–bolus insulin or OADs. However, large observational trials documented improvements in glycated hemoglobin, PPG, and hypoglycemia with BIAsp 30 in multi-ethnic patient populations. In summary, this literature review demonstrates that premixed insulin regimens are an appropriate and effective treatment choice in T2D.

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“…[ 57 58 59 60 ] An improvement in hypoglycemia with BIAsp 30 was also reported in this and other observational trials. [ 54 55 57 58 59 60 ]…”

Section: Discussionsupporting

confidence: 70%

“…[ 56 ] Numerous country-specific findings from A 1 chieve have shown improvements from baseline to week 24 in HbA1c, PPG, hypoglycemia, and quality of life. [ 57 58 59 60 ]…”

Section: O Verview Of K Ey O mentioning

confidence: 99%

Efficacy and safety of biphasic insulin aspart and biphasic insulin lispro mix in patients with type 2 diabetes: A review of the literature

Kumar

2016

Indian J Endocr Metab

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Drug-related risk of severe hypoglycaemia in observational studies: a systematic review and meta-analysis

Czech

Rdzanek²,

Paweska³

et al. 2015

BMC Endocr Disord

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BackgroundDiabetes mellitus (DM) leads to multiple complications, including severe hypoglycaemia events (SHEs). SHEs can impact a patient’s quality of life and compliance and may directly result in additional costs to the health care system. The aim of this review was to evaluate the risk of severe hypoglycaemia in patients with type 1 (T1) and 2 (T2) DM as observed in everyday clinical practice for various drug regimens.MethodsWe conducted a systematic review of observational (retrospective or prospective) studies in the MEDLINE, Embase, and Cochrane Library databases that covered at least 100 children or adults with T1/T2 DM. In T1 DM, basal-bolus/pre-mix insulin (human or analogue) and insulin pump were reviewed, and in T2 DM, basal-bolus/pre-mix insulin (human or analogue), oral antidiabetic drugs supported with basal insulin (human or analogue), sulfonylureas in monotherapy, and combined oral treatment were reviewed. In order to estimate SHE rates, we extracted data on the time horizon of the study, number of patients, number of SHEs, and number of patients experiencing at least one SHE. We used a random effects model to estimate the annual SHE rate. We considered the risk for other antidiabetic medications in T2 DM to be negligible and the results of our main review yielded no observational data for premixes in T1 DM so they were assessed based on relative rates taken from additional systematic reviews. The study, being a desk research, did not involve any human subjects (including human material or human data) and no ethical committee approval was asked for. For the same reason there was no need to collect informed consent for participation in the study.ResultsWe identified 76 observational studies encompassing 707,722.30 patient-years. The estimated annual SHE rate varied from 0.168 (95 % CI 0.123–0.237) for insulin pump up to 1.628 for biphasic human insulin in T1 DM patients, and from 0.0035 for oral antidiabetic drugs up to 0.554 (95 % CI 0.157–7.534) for basal-bolus with human insulin in T2 DM patients.ConclusionsOur review indicates that SHE rates differ between patients depending on treatment regimen. However, SHEs are also driven by other factors. Proper modelling techniques are needed to use various types of information in published studies.Electronic supplementary materialThe online version of this article (doi:10.1186/s12902-015-0052-z) contains supplementary material, which is available to authorized users.

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Insulin therapy for elderly patients with type 2 diabetes mellitus

Petunina,

Kuzina,

Telnova

et al. 2024

Medicinskij sovet

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The prevalence of type 2 diabetes among older people is increasing every year. The main pathogenetic mechanisms of type 2 diabetes in elderly patients include disruption of the intestinal microbiota, cellular aging, oxidative stress and mitochondrial dysfunction, immune and inflammatory processes. Short-chain fatty acids produced by the intestinal microbiota influence inflammatory processes in pancreatic β-cells. Cellular senescence causes the secretion of different cytokines, chemokines, growth factors and proteases, exacerbating the proinflammatory state and increasing insulin resistance of the tissues. Oxidative stress and mitochondrial dysfunction decrease the ATP synthesis process and increase the formation of reactive oxygen species. Changes in the immune system in elderly patients contribute to autoimmune processes and systemic inflammation. Clinical features of diabetes mellitus in old age include asymptomatic progression, impaired recognition of hypoglycemia, impaired cognitive function, and muscle atrophy. The progressive decline in β-cells function in type 2 diabetes requires insulin therapy in many patients. Biphasic insulins allow to control both basal and postprandial glycemia, are easy to use and are indicated for patients who have difficulty counting amount of carbohydrates. However, it is worth remembering a balanced approach to prescribing and deintensifying therapy.

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Clinical experience with BIAsp 30: Results from the Indonesian cohort of the international A1chieve study

Cited by 3 publications

References 16 publications

Efficacy and safety of biphasic insulin aspart and biphasic insulin lispro mix in patients with type 2 diabetes: A review of the literature

Efficacy and safety of biphasic insulin aspart and biphasic insulin lispro mix in patients with type 2 diabetes: A review of the literature

Drug-related risk of severe hypoglycaemia in observational studies: a systematic review and meta-analysis

Insulin therapy for elderly patients with type 2 diabetes mellitus

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