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Review of biphasic insulin aspart in the treatment of type 1 and 2 diabetes.

Raja-Khan N, Warehime SS, Gabbay RA - Vasc Health Risk Manag (2007)

Bottom Line: Our goal was to review the current literature on the safety and efficacy of biphasic insulin aspart in type 1 and type 2 diabetes.Biphasic insulin aspart more effectively reduces post-prandial glucose compared to other biphasic insulins and basal insulins.Biphasic insulin aspart 70/30 is a safe and effective treatment option for patients with diabetes.

View Article: PubMed Central - PubMed

Affiliation: Division of Endocrinology, Diabetes, and Metabolism, Penn State Institute for Diabetes and Obesity, Pennsylvania State University College of Medicine, Hershey 17033, USA. nrajakhan@psu.edu

ABSTRACT

Background: Insulin is an effective treatment for achieving glycemic control and preventing complications in patients with diabetes. In order to make insulin therapy more acceptable to patients, newer formulations of insulin have been developed, such as biphasic insulins. Biphasic insulins conveniently provide both prandial and basal insulin in a single injection. One of the most well-studied biphasic insulins is biphasic insulin aspart 70/30.

Objective: Our goal was to review the current literature on the safety and efficacy of biphasic insulin aspart in type 1 and type 2 diabetes.

Methods: A MEDLINE search was conducted using the terms "biphasic insulin aspart" to identify clinical studies and reviews.

Results: Biphasic insulin aspart more effectively reduces post-prandial glucose compared to other biphasic insulins and basal insulins. Compared to biphasic insulin aspart, fasting glucose levels are lower with NPH, similar with glargine, and similar or lower with biphasic human insulin. Treat-to-target trials have shown that a goal HbA1c below 6.5 or 7% can be achieved with biphasic insulin aspart. The risk of hypoglycemia is similar to or less than that seen with other biphasic insulins or NPH insulin.

Conclusion: Biphasic insulin aspart 70/30 is a safe and effective treatment option for patients with diabetes.

Show MeSH

Related in: MedlinePlus

Total post-prandial glucose (PPG) excursions (0–5 hours) with biphasic insulin aspart 70/30 (BIAsp 30) compared to biphasic insulin lispro 75/25 (Mix 25), and biphasic human insulin 70/30 (BHI 30) in an open-label, 3-period, crossover study of 45 patients with type 2 diabetes. Reprinted from Halimi S, Raskin P, Liebl A, et al. 2005. Efficacy of biphasic insulin aspart in patients with type 2 diabetes. Clin Ther, 27:S57–74. Copyright © 2005 with permission from Excerpta Medica, Inc.
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Related In: Results  -  Collection


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fig2: Total post-prandial glucose (PPG) excursions (0–5 hours) with biphasic insulin aspart 70/30 (BIAsp 30) compared to biphasic insulin lispro 75/25 (Mix 25), and biphasic human insulin 70/30 (BHI 30) in an open-label, 3-period, crossover study of 45 patients with type 2 diabetes. Reprinted from Halimi S, Raskin P, Liebl A, et al. 2005. Efficacy of biphasic insulin aspart in patients with type 2 diabetes. Clin Ther, 27:S57–74. Copyright © 2005 with permission from Excerpta Medica, Inc.

Mentions: Only one study has compared the effectiveness of biphasic insulin aspart 70/30 and biphasic insulin lispro 75/25 (75% protaminated lispro and 25% soluble lispro), another commercially available biphasic insulin analog. This was an open-label, three period crossover study in which 61 insulin-treated patients with type 2 diabetes and HbA1c 8.3 ± 1.1% received a single injection of biphasic insulin aspart 70/30, biphasic insulin lispro 75/25, and biphasic human insulin 70/30, before breakfast on each of 3 separate days (Hermansen, Colombo et al 2002). Significantly fewer PPG excursions were observed after biphasic insulin aspart 70/30 compared to after biphasic insulin lispro 75/25 and to after biphasic human insulin 70/30, which suggests that biphasic insulin aspart more effectively reduces PPG compared to other biphasic insulins (Figure 2). The mean baseline fasting serum glucose was comparable between the two groups (151.2–154.8 mg/dL). A total of 53 hypoglycemic episodes were reported during the study days, including 23 episodes with biphasic insulin aspart, 11 episodes with biphasic human insulin, and 19 episodes with biphasic insulin lispro. Most of these episodes were mild, based on symptoms only, not confirmed with blood glucose measurement, and resolved spontaneously. There were a few severe hypoglycemic episodes requiring assistance from another person, including 2 episodes with biphasic insulin aspart, 2 episodes with biphasic human insulin, and 5 episodes with biphasic insulin lispro.


Review of biphasic insulin aspart in the treatment of type 1 and 2 diabetes.

Raja-Khan N, Warehime SS, Gabbay RA - Vasc Health Risk Manag (2007)

Total post-prandial glucose (PPG) excursions (0–5 hours) with biphasic insulin aspart 70/30 (BIAsp 30) compared to biphasic insulin lispro 75/25 (Mix 25), and biphasic human insulin 70/30 (BHI 30) in an open-label, 3-period, crossover study of 45 patients with type 2 diabetes. Reprinted from Halimi S, Raskin P, Liebl A, et al. 2005. Efficacy of biphasic insulin aspart in patients with type 2 diabetes. Clin Ther, 27:S57–74. Copyright © 2005 with permission from Excerpta Medica, Inc.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2350128&req=5

fig2: Total post-prandial glucose (PPG) excursions (0–5 hours) with biphasic insulin aspart 70/30 (BIAsp 30) compared to biphasic insulin lispro 75/25 (Mix 25), and biphasic human insulin 70/30 (BHI 30) in an open-label, 3-period, crossover study of 45 patients with type 2 diabetes. Reprinted from Halimi S, Raskin P, Liebl A, et al. 2005. Efficacy of biphasic insulin aspart in patients with type 2 diabetes. Clin Ther, 27:S57–74. Copyright © 2005 with permission from Excerpta Medica, Inc.
Mentions: Only one study has compared the effectiveness of biphasic insulin aspart 70/30 and biphasic insulin lispro 75/25 (75% protaminated lispro and 25% soluble lispro), another commercially available biphasic insulin analog. This was an open-label, three period crossover study in which 61 insulin-treated patients with type 2 diabetes and HbA1c 8.3 ± 1.1% received a single injection of biphasic insulin aspart 70/30, biphasic insulin lispro 75/25, and biphasic human insulin 70/30, before breakfast on each of 3 separate days (Hermansen, Colombo et al 2002). Significantly fewer PPG excursions were observed after biphasic insulin aspart 70/30 compared to after biphasic insulin lispro 75/25 and to after biphasic human insulin 70/30, which suggests that biphasic insulin aspart more effectively reduces PPG compared to other biphasic insulins (Figure 2). The mean baseline fasting serum glucose was comparable between the two groups (151.2–154.8 mg/dL). A total of 53 hypoglycemic episodes were reported during the study days, including 23 episodes with biphasic insulin aspart, 11 episodes with biphasic human insulin, and 19 episodes with biphasic insulin lispro. Most of these episodes were mild, based on symptoms only, not confirmed with blood glucose measurement, and resolved spontaneously. There were a few severe hypoglycemic episodes requiring assistance from another person, including 2 episodes with biphasic insulin aspart, 2 episodes with biphasic human insulin, and 5 episodes with biphasic insulin lispro.

Bottom Line: Our goal was to review the current literature on the safety and efficacy of biphasic insulin aspart in type 1 and type 2 diabetes.Biphasic insulin aspart more effectively reduces post-prandial glucose compared to other biphasic insulins and basal insulins.Biphasic insulin aspart 70/30 is a safe and effective treatment option for patients with diabetes.

View Article: PubMed Central - PubMed

Affiliation: Division of Endocrinology, Diabetes, and Metabolism, Penn State Institute for Diabetes and Obesity, Pennsylvania State University College of Medicine, Hershey 17033, USA. nrajakhan@psu.edu

ABSTRACT

Background: Insulin is an effective treatment for achieving glycemic control and preventing complications in patients with diabetes. In order to make insulin therapy more acceptable to patients, newer formulations of insulin have been developed, such as biphasic insulins. Biphasic insulins conveniently provide both prandial and basal insulin in a single injection. One of the most well-studied biphasic insulins is biphasic insulin aspart 70/30.

Objective: Our goal was to review the current literature on the safety and efficacy of biphasic insulin aspart in type 1 and type 2 diabetes.

Methods: A MEDLINE search was conducted using the terms "biphasic insulin aspart" to identify clinical studies and reviews.

Results: Biphasic insulin aspart more effectively reduces post-prandial glucose compared to other biphasic insulins and basal insulins. Compared to biphasic insulin aspart, fasting glucose levels are lower with NPH, similar with glargine, and similar or lower with biphasic human insulin. Treat-to-target trials have shown that a goal HbA1c below 6.5 or 7% can be achieved with biphasic insulin aspart. The risk of hypoglycemia is similar to or less than that seen with other biphasic insulins or NPH insulin.

Conclusion: Biphasic insulin aspart 70/30 is a safe and effective treatment option for patients with diabetes.

Show MeSH
Related in: MedlinePlus