To examine the impact on glycemie control of substituting a range of premixed insulins for the standard treatment with patient-mixed insulin combinations. In addition, a pen-type syringe was substituted for the conventional insulin syringe, and the patients' preference wasascertained at the end of the study.
Before the study, all patients had maintained a constant insulin dosage for 2 months. For the first month of the study, all patients were encouraged to make any adjustment in insulin dosage required to optimize control. Twenty-seven patients participated in the study. At the end of the first month, patients were randomized either to change to premixed insulins or to continue with self-mixed insulins for 2 months. At the end of the 2-month period, participants changed to the alternative regime for a further 2 months. Glycemie control was measured by assessment of glycosylated hemoglobin levels at the start of the study and aftereach 2-month period of the study. In addition, during the 1-month run-in period and during both 2-month study periods, a seven-point blood glucose profile was obtained extending from before breakfast to just before retiring for sleep.
Glycosylated hemoglobin levels were unchanged throughout the duration of the study. Similarly, there were no systematic changes inindividual seven-point blood glucose profiles. The frequency of hypoglycemie reactions was similar on patient-mixed and premixed insulin programs. However, 83% of patients expressed a preference for premixed insulins. A similar percentage regarded pen-type insulin syringes to be preferable to the conventional syringe.
Glycemie control was similar on patient-mixed and premixed insulins, and patients had a marked preference for premixed insulins delivered in a pen-type syringe over conventional insulin therapy. Premixed insulin delivered by a pen-type syringe promises to ease the burden of daily injections for many diabetic patients.
