Premixed Insulin May Offer Better Blood Sugar Control

Study compared these formulations to long-acting insulin and other medications

By Amanda Gardner
HealthDay Reporter

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WEDNESDAY, Sept. 17 (HealthDay News) -- Premixed insulin, which combines short- and long-acting versions of the hormone, results in better blood-sugar control as compared with long-acting insulin alone or oral medications, a new study finds.

But it's not clear that this tighter glycemic control translates into fewer complications and a lower mortality rate among people suffering from type 2 diabetes, researchers add.

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And two types of premixed insulin -- premixed human insulin and premixed insulin analogues (genetically engineered human insulin) -- appeared to produce the same benefit.

Various premixed products are already on the market, but the results described in a study in the Sept. 16 issue of Annals of Internal Medicine may help better determine which product benefits which patient.

More than a quarter of patients with type 2 diabetes use insulin alone (16 percent) or insulin combined with an oral medication (12 percent) to help them control their blood-glucose levels.

And as the number of people overall who have type 2 diabetes continues to increase, information on the effectiveness and safety of premixed insulin is even more imperative.

Premixed insulin includes both long- and short-acting insulin together in one preparation. These products are intended to give patients more flexibility as to when they eat.

"This is supposed to treat the post-meal sugar and also the blood sugars for eight to 12 hours after injection," explained Dr. Spyros Mezitis, an endocrinologist with Lenox Hill Hospital and assistant professor of medicine at New York Presbyterian Hospital/Cornell Medical Center in New York City. "It has more flexibility."

One injection of long-acting insulin would cover 24 hours, with four short-acting injections given in-between to cover meals.

With premixed, however, patients typically only need two injections: one before breakfast and one before dinner. The first injection covers breakfast and peaks at lunch but disappears by dinner time, at which time a second injection will take care of things until the next morning, explained study lead author Dr. Rehan Qayyum, assistant professor of medicine at Johns Hopkins School of Medicine in Baltimore.

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