Comparison of insulin aspart and human soluble insulin during insulin pump therapy in type 2 diabetes

Objective: Continuous subcutaneous insulin infusion(CSII) with human insulin has been available for many years,but only recently have reports of efficacy with rapid-acting insulin analogues been published.The purpose of this study is to compare the efficacy,safety and the difference character between the two type insulin form in CSII. Methods: A total of 345 patients with type 2 diabetes were recruited and randomized into Groups A(n = 173) and B(n = 172),treated with insulin aspart and humulin R,respectively,by CSII.Capillary glucose concentrations were measured at 9 time points,before and after the three meals,at bedtime(10 p.m.),midnight(0 a.m.) and 3 a.m.every day during the treatment. Results: The time to achieve good glycemic control was(4.40 ± 2.16) d in Group A,significantly shorter than(5.68 ± 2.29) d in Group B(P 0.05),but the total insulin dose was similar between the two groups(P 0.05),and the dose of basal insulin was smaller in the former than in the latter(P 0.05).After the treatment,blood glucose was significantly reduced in both of the groups,while the levels of fasting blood glucose and post-breakfast and post-dinner blood glucose were far more decreased in Group A than in B(P 0.05).The incidence of hypoglycemia was significantly lower in the aspart group than in the humulin R group(P 0.05).Conclusion: Insulin aspart can effect a better control of blood glucose and a lower incidence of hypoglycemia than Humulin R in diabetic patients during the CSII treatment.The basal insulin dose is smaller in the insulin aspart group than in the human insulin group,especially in the daytime.