Published in:
01-03-2014 | Original Article
Diurnal patterns of plasma glucose in patients with type 2 diabetes receiving sulfonylurea and effectiveness of once daily lispro mix 50/50 injections
Published in: Diabetology International | Issue 1/2014
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Aims
To evaluate diurnal patterns of plasma glucose in Japanese patients with type 2 diabetes receiving sulfonylurea and the effectiveness of daily premixed biphasic insulin analog (insulin lispro mix 50/50) injections plus sulfonylurea before breakfast (Mid mixture insulin analog-supported Oral Therapy, MOT).
Subjects and methods
Study 1: We evaluated 7-point plasma glucose profiles for 108 patients with type 2 diabetes stratified by their glycated hemoglobin A1c (HbA1c) levels into groups 1 (HbA1c < 7.4 %; n = 11), 2 (7.4 % ≤ HbA1c < 8.4 %; n = 33), 3 (8.4 % ≤ HbA1c < 9.4 %; n = 24), and 4 (9.4 % ≤ HbA1c; n = 40). Study 2: We initiated MOT in another 15 patients and evaluated its effectiveness for 24 weeks.
Results
We observed significant differences in mean plasma glucose levels between groups 1 and 2 after breakfast, groups 2 and 3 before dinner and at bedtime, and groups 3 and 4 during fasting and at bedtime. We observed significant postprandial changes in plasma glucose levels only before and after breakfast, and this was significantly higher in groups 3 and 4 than in group 1. A week after MOT initiation, the plasma glucose levels from the fasting period to before dinner decreased significantly, and HbA1c levels, which were 9.0 % at baseline, decreased significantly to 7.4 % at week 12 and 7.5 % at week 24.
Conclusions
We elucidated the association between plasma glucose levels after breakfast and HbA1c levels. From the results, MOT could be a promising strategy of early insulin initiation for patients with type 2 diabetes receiving sulfonylurea.