Comparison of daily glucose excursion by continuous glucose monitoring between type 2 diabetic patients receiving biphasic insulin aspart 30 or biphasic human insulin 30

Aims/Introduction: Biphasic insulin aspart 30 (BIAsp 30) has an earlier and stronger peak effect with a similar duration of action to biphasic human insulin 30 (BHI 30). However, direct comparison of daily glucose excursion during treatment with these two types of insulin has not been carried out. Materials and Methods: We carried out continuous glucose monitoring (CGM) and evaluated the 48-h glucose profile during twice-daily injections of BIAsp 30 or BHI 30 at the same dosage in 12 hospitalized patients with type 2 diabetes who participated in a randomized cross-over trial. Results: The 48-h average glucose level and mean amplitude of glucose excursion (MAGE) were lower during BIAsp 30 treatment than with BHI 30. The average glucose level during 2-3 h after breakfast and 2-4 h after dinner, and the incremental postprandial glucose from just before to 4 h after dinner were lower with BIAsp 30 treatment than with BHI 30. Furthermore, BIAsp 30 treatment reduced the SD from 30 min before to 4 h after breakfast and lunch compared with BHI 30. The average glucose level and SD during the 30 min before each meal and during the night were not different between the two insulin preparations, and hypoglycemia was not observed with either treatment. Conclusions: Twice-daily BIAsp 30 reduced the 48-h average glucose and MAGE, the postprandial glucose (after breakfast and dinner), and the SD of glucose excursion (after breakfast and lunch) compared with the same dosage of BHI 30, without causing hypoglycemia or deterioration of glycemic control before meals and at night. This trial was registered with UMIN (no. UMIN000005129). (J Diabetes Invest, doi: 10.1111/j.2040-1124.2011.00123.x, 2011)