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Prandial insulin best for hitting HbA1c target

By Christian Duffin

More patients with type 2 diabetes on prandial insulin reach HbA1c targets compared with other insulin analogue regimens, according to the results of a meta-analysis.

The Italian researchers analysed data from 7,759 patients drawn from 16 randomised controlled trials of between three and 36 months duration.

Biphasic patients were 88% more likely to achieve the target of 7% or lower HbA1c level, and patients on prandial insulin and more than two times more likely, with an odds ratio of 2.07. Both treatments were compared to basal insulin.

But treatment with biphasic insulin was associated with a 34% greater incidence of hypoglycaemia and weight gain.

Professor Dario Guigliano, professor of metabolic diseases at the Second University of Naples, Italy, concluded: ‘A greater proportion of type 2 diabetic patients can achieve the less than 7% goal with biphasic or prandial insulin compared with basal insulin.’

Diabetes Care, online 7 January 2011

Prandial insulin best for hitting HbA1c target