The Impact of Prandial Plus Basal Compared to Basal Insulin on Glycemic Variability in Type 2 Diabetes Patients. Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists [Endocr Pract] Journal article

Objective: Higher glycemic variability is associated with increased level of oxidative stress and inflammation in type 2 diabetes patients. Clinicians have several options in selecting insulin treatment for those patients requiring insulin to control hyperglycemia. Use of treatments which reduce glycemic variability may be beneficial. We hypothesized that metformin (Met)- treated patients given an analog mixture of basal and rapid-acting insulins (insulin lispro protamine suspension [ILPS] + insulin lispro) would have less glycemic variability than those given basal insulin glargine.
Methods: Two post-hoc analyses were used to compare 7-point blood glucose (BG) profiles from three published studies comparing insulin lispro mixtures (LM) with insulin glargine (G) in Mettreated type 2 diabetes patients. Glycemic variability indices used: standard deviation (SD) of the mean daily BG, coefficient of variation (CV), M-value, Mean Amplitude of Glycemic Excursion (MAGE) and J-index.
Results: Patients on the twice-daily LM75/25 (75% ILPS /25% lispro [LM75/25]) +Met regimen, compared with G+Met, had significantly lower SD, M-value, and J-index but not CV or MAGE. Patients on thrice-daily LM50/50 (50% ILPS /50% lispro [LM50/50]) +Met, compared with G+Met, had significantly lower values for all five indices.
Conclusions: Use of basal+prandial insulin lispro mixtures at two or three meals was associated with lower glycemic variability in metformin-treated type 2 diabetes patients.

Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists [Endocr Pract]