Biphasic insulin aspart 70/30 three times a day in older patients with type 2 diabetes not achieving optimal glycemic control on a twice-daily regimen: A retrospective case series analysis from clinical practice

This retrospective study was conducted to determine whether the addition of a third injection of biphasic insulin aspart 70/30 (BlAsp 30) just before lunch in older patients with type 2 diabetes who did not achieve goals with a twice-daily (BID) regimen would optimize glycemic control in a clinical practice setting. A retrospective chart analysis was conducted. In 12 patients aged 52 to 80 y with type 2 diabetes that had been diagnosed between 5 and 24 y earlier and who remained on oral antidiabetes agents, a third injection of BlAsp 30 was added because optimal glycemic control (glycosylated hemoglobin [HbA(1c)] < 7%) was not achieved on a BID regimen. Changes in HbA(1c), body weight, total insulin dose, and frequency of hypoglycemia were analyzed after 6 mo of three times daily (TID) treatment. Mean HbA, decreased from 8.4% to 7.2%. An HbA, goal of < 7% was attained by 58% of patients. Although the total insulin dose increased by 11% with the TID regimen, pre-breakfast and pre-dinner doses decreased by 15%. No patient experienced major hypoglycemia on BID or TID dosing. With the TID regimen, no minor hypoglycennic events were reported by patients and mean body weight decreased by 2.25 lb. The addition of a third injection of BlAsp 30 substantially improved HbA(1c) and decreased body weight and the incidence of hypoglycemia in 12 patients with type 2 diabetes who did not achieve optimal glycemic control on a BID regimen.