People with Type 2 Diabetes on Premixed Insulin Therapy: How is the Daily Insulin Dose Partitioned and are there Effects on the Metabolic Control?

Abstract

The quite common recommendation in German and Austrian medical textbooks, that premixed insulin therapy should consists of a dose distribution with two thirds before breakfast and one third before dinner, is not observed in daily practice. Diurnal insulin dose distribution and HbA1c are not associated in this cohort. Novelty statement: The circadian insulin dose distribution of 2/3 before breakfast and 1/3 before dinner could not be confirmed for patients with diabetes type 2 and conventional insulin therapy. No correlation between metabolic control and insulin circadian insulin dose distribution was detected.

Commentary on “Effects of Long-Term Exercise Interventions on Glycaemic Control in Type 1 and Type 2 Diabetes: A Systematic Review”

“…Current guidelines for physical exercise in diabetes are often rather vague in their recommendations and advices for intensity are so time demanding that only a few patients can are able to fullfill them, e. g., high levels of physical activity with 150-300 min/week [1,2]. Recommendations mainly focus on weight loss only but not on improvement of glycemic control, reduction of medication or other risk factors and culprits of the underlying disease which are improved by physical activity [3][4][5][6]. Further, in diabetic drug treatments an individualised approach has successfully been established in the recent years, while for lifestyle interventions an individualised approach is still lacking [7].…”