Application of insulin dose spectrum after an intensive insulin pump therapy in type 2 diabetes mellitus

doi:10.3969/j.issn.1004-583X.2024.07.006

Abstract

Abstract:

Objective To explore the treatment time, timing and type of premixed insulin analogs in patients with type 2 diabetes mellitus (T2DM). Methods A total of 655 T2DM patients treated with continuous subcutaneous insulin infusion(CSII) short-term intensive treatment in 5 hospitals in Ningbo City, China were recruited to determine the optimal treatment plan of premixed insulin analogs. Results After CSII titration, the ratio of insulin dosage before meals to total basal insulin was 1.12, with the total insulin dosage of 51.35±29.7 U. 58% of T2DM patients were recommended to the use of premixed insulin analogs before dinner. 74% of them were recommended to the use of low premixed insulin analogs before breakfast. An individualized preparation of premixed insulin analogs with varied dosage formulations was expected to yield the optimal goal to control blood sugar. An inferred ratio of premixed insulin analogs twice a day (b.i.d.) in the morning and evening was 3∶2. A higher dosage in the morning than evening favored a simple informed consent of insulin dosage, thus preventing the misuse of premixed insulin analog dosages in the morning and evening and the incidence of hypoglycemia. An intensive insulin pump therapy showed that the insulin dose spectrum of T2DM was extremely heterogeneous, and a quantitative selection was of more significance. Conclusion A premixed insulin analog regimen b.i.d. is recommended, with a medium premixing before dinner, and low premixing before breakfast. A single type of insulin is dominant in clinical treatment of T2DM. An optimal regimen of the two types of premixed insulin analogs, either combined with oral hypoglycemic drugs or not, can be selected based on the individualized conditions of blood sugar.

Key words: diabetes mellitus, type 2, insulin pump, insulin dose profile, premixed insulin

CLC Number:

R587.1

Du Sina, Li Wei, Lin Yajing, Sun Jianguo, Mao Mao, Chen Jianwei, Sun Danbo, Mao Yushan. Application of insulin dose spectrum after an intensive insulin pump therapy in type 2 diabetes mellitus[J]. Clinical Focus, 2024, 39(7): 620-624.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2024.07.006

https://huicui.hebmu.edu.cn/EN/Y2024/V39/I7/620

Figures/Tables 7

Fig.1 Blood glucose control after CSII titration

Fig. 2 Insulin dosage after CSII titration and simulated dosage for BID

Tab.1 Simulated conversion ratio of premixed insulin analogues after CSII titration

模拟晚餐前品种	例数	模拟早餐前品种与晚餐前品种匹配
模拟晚餐前品种	例数	中预混	低预混
中预混	379	121	258
低预混	276	227	49

Fig.3 Prediction distribution of premixed insulin dosage forms before dinner

Fig.4 Distribution of the dosage form of middle premixed insulin analogs for breakfast predicted in dinner

Fig.5 Distribution of the dosage form of low premixed insulin analogs for breakfast predicted before dinner

Fig.6 Distribution of dosage forms of premixed insulin analog selected before breakfast

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