Comparation of insulin glargine and isophane protamine biosynthetic human insulin in treatment of type 2 diabetes

AIM:To compare the effects and the risks of hypoglycemia of insulin glargine(qd)and iso- phane protamine biosynthetic human insulin(pre-mixed insulin,bid)under the condition of unsuccessful control of the blood glucose with oral hypoglycemic agents.METHODS:Forty type 2 diabetes patients with unsuccess- ful blood glucose control through oral hypoglycemic agents were divided into two groups randomly:glargine group (n=20)and pre-mixed insulin group(n=20).Under the same primary oral drugs administration,the patients of glargine group were injected with the insulin glargine hypodermicly once at 10 o'clock every night and the pa- tients of pre-mixed group were injected with the pre-mixed insulin hypodermicly before the morning and evening meals respectively for 16 weeks.The doses of insulin were adjusted each week according to the levels of fasting blood glucose(FBG)in order to reach the standard of less than 5.6 mmol·L~(-1).RESULTS:The FBG of two groups reduced obviously at the 4 and 16 weeks after the treatment,with much more decrease in glargine group than that in pre-mixed group(P＜0.01).The levels of glycosylated hemoglobin(HbA_(1c))in two groups fell markedly,showing no significant difference between them(P＞0.05).The dose of insulin used in pre-mixed group was(23±s 6)U,higher than that in glargine group significantly(16±3)U(P＜0.05).The incidence of hypoglycemia in glargine group was obviously lower than that in pre-mixed group(3 patients in glargine group,9 patients in pre-mixed group,X~2=4.285,P＜0.05).CONCLUSION:Under unsuccessful control of blood glu- cose with oral hypoglycemic agents,both insulin glargine(qd)and the pre-mixed insulin(bid)possess obvious effects of controlling the FBG,but the former is superior in lowing the incidence of hypoglycemia with smaller dose than the latter.