Biphasic Insulin Aspart 30 in Insulin Initiation

This case report concerns a patient with poor glycaemic control on oral antidiabetic drugs who initiated biphasic insulin aspart 30 (BIAsp 30), and reviews supporting clinical literature, alternative treatment choices and the options for intensification. During the six-month follow-up after initiation of BIAsp 30, glycosylated haemoglobin (HbA1c) was reduced from 10.2 % to 6.4 %, mean fasting blood glucose (FBG) was reduced from 9.0 mmol/l to 6.8 mmol/l and mean postprandial glucose (PPG) was reduced from 15.3 mmol/l to 8.8 mmol/l. Body weight increased by 4 kg. The patient experienced eight episodes of hypoglycaemia over the six-month period (four pre-lunch, one at bedtime and three nocturnal). The patient had six episodes with blood glucose (BG) <4.0 mmol/l but no episodes with BG <2.8 mmol/l. Insulin initiation with a premix insulin analogue offers a simple and convenient regimen of once- or twice-daily dosing and provides effective glycaemic control by providing coverage of both FBG and PPG.