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2015 ; 6
(3
): 273-87
Nephropedia Template TP
gab.com Text
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Twit Text #
English Wikipedia
Practical Guidance on the Use of Premix Insulin Analogs in Initiating,
Intensifying, or Switching Insulin Regimens in Type 2 Diabetes
#MMPMID26104878
Wu T
; Betty B
; Downie M
; Khanolkar M
; Kilov G
; Orr-Walker B
; Senator G
; Fulcher G
Diabetes Ther
2015[Sep]; 6
(3
): 273-87
PMID26104878
show ga
INTRODUCTION: Premix insulin analogs are a well-established treatment for type 2
diabetes (T2D). However, there is a lack of simple, clear guidance on some
aspects of their use. These include choosing a regimen for insulin initiation,
recognizing when patients need intensification of therapy, and switching from
basal-bolus to a premix insulin analog when appropriate. METHODS: An independent
expert panel formulated recommendations on the use in T2D of the premix insulin
analog formulations widely available in Australasia, based on the available
evidence and their own experience. RESULTS: Results from trials in both
initiation and intensification of insulin show that no single insulin or regimen
is best on all endpoints, and that improved glycemic control can be expected
regardless of which regimen is used. Thus, individual patient factors and
preferences become more important. Guidance is presented to help the clinician
choose between a premix insulin analog or basal analog for insulin initiation,
and to intensify insulin therapy using premix insulin analogs. Recommendations
are made on dosing, titration, the concomitant use of non-insulin
glucose-lowering drugs, and other practical issues, and on the special case of
switching from basal-bolus to premix insulin analog therapy. CONCLUSION: This
guidance is intended to help both general and specialist practitioners make
informed choices and provide optimal care for patients with T2D. It emphasizes
the importance of taking into account individual patient factors and preferences
so that the choice of insulin regimen is individualized to the patient in the
same way that glycemic targets are now individualized. FUNDING: Novo Nordisk
Region IO A/S.