Treatment intensification with insulin analogs in type 2 diabetics

Abstract

Nowadays we can observe the increasing prevalence of diabetes all over the world. Despite new hipoglycaemic drugs implementation, including modern insulin products the metabolic control of diabetes does not improve. Generally it results from too late introducing insulinotherapy or noneffective treatment intensification. In this paper we present insulin analogues efficiacy and safety profile in beginning or advancement in 1492 patients with diabetes type 2. Data were collected from observative questionnaire research of two visits with 3 months interval. The mean time of diabetes duration was 9.77 years. Mean HbA_1c level - 8.86%, fasting blood glucose 160 mg/dl, postprandial glucose 216 mg/dl. The commonest cause of treatment intensification was abnormal postprandial glucose (88.5%), fasting glucose (73.8%) and HbA_1c (38.6%). Modification of insulinotherapy was personalized. NovoRapid and Insulatard or NovoMix30 in monotherapy or together with NovoRapid were used. Treatment change caused decrease of HbA_1c level to 7.7%, fasting glycaemia to 123.46 mg/dl and post prandial glucose to 155.32 mg/dl. Differences were statistically significant. 76.9% of patients considered the treatmnet more comfortable. Number of hypoglycaemia was lower. One of the most important factors influencing the new treatment efficiacy is better patient compliance depending on time of insulin injection - immediately before a meal.