Biphasic insulin aspart 30 treatment in patients with type 2 diabetes poorly controlled on prior diabetes treatment: Results from the PRESENT study

Aim: The safety and efficacy of biphasic insulin aspart (BIAsp30) were evaluated in patients uncontrolled on previous treatment (human insulin ± oral hypoglycaemic agent [OHA] or OHA only) in routine clinical practice. Methods: This was a large, multi-national, multicentre, prospective, 6-month study in type 2 diabetes mellitus patients who were prescribed BIAsp30. Changes in glycated haemoglobin (HbA1c), fasting plasma glucose (FPG), postprandial plasma glucose (PPPG), proportion who achieved target HbA 1c < 7% and rate of hypoglycaemic episodes were assessed. This paper evaluates outcomes in patients by diabetes duration (< 5, 5-10, 10-20 or ≥ 20 years) stratified by prior therapy. Results: After 6 months of treatment, glycaemia improved significantly across the duration subgroups. The improvement was better in insulin-naïve group versus prior insulin group: HbA1c decreased ∼ 2.2%-points versus ∼ 1.6%-points, FPG decreased ∼ 4.5 mmol/L versus ∼ 2.9 mmol/L and PPPG decreased ∼ 6.8 mmol/L versus ∼ 5.0 mmol/L. Target HbA1c was achieved by about one in four patients although insulin-naïve patients achieved this at comparatively lower BIAsp30 dose. Body weight remained relatively unchanged. Hypoglycaemic episodes appeared to be more frequent in the prior insulin group which decreased during the treatment period. Conclusions: According to this observational study, in clinical practice, initiating or transferring uncontrolled patients to biphasic insulin aspart improved glycaemic control without using a strict insulin algorithm. © 2008 Librapharm Limited All rights reserved.