Endocrine Abstracts

Background and aims: Many obese patients with type 2 diabetes mellitus (T2DM) are not adequatly controlled with oral antidiabetic therapy (OAD), even with combination between metformin and sulfonylurea (SU). When OADs no longer maintain good glycaemic control in obese T2DM, it is necessary to add insulin therapy. The aim of this study is to compare the effect of adding premixed insulin aspart 30(BIAsp30) vs. premixed human insulin 30/70 (BHI30) to support metformin therapy in obese T2DM patients.

Materials and methods: 50 obese type T2DM patients, BMI 34±2 kg/m², poorly controlled by OADs (metformin+SU) in maximal doses, HbA1c 9.4±1.3%. 30 of them were treated with adding BHI30 in combination with metformin. 20 of them were treated with BIAsp30 in combination with metformin. Duration of the study was 3 months. Efficacy was assessed by analysis of HbA1c, FPG, postprandial glycaemia, blood glucose profile, and hypoglycaemic episodes.

Results: HbA1c decreased in both groups, but significantly lower in BIAsp30+ metformin group vs. BHI30+ metformin group. FPG decreased during the study in both groups, but postprandial glycaemia was significantly lower in BIAsp30+ metformin group. Hypoglycaemic episodes didn’t differ significantly in both groups.

Conclusion: In obese patients with T2DM, poorly controlled by OADs, insulinisation with BIAsp30 and BHI30 in combination with metformin provides significant improvement in HbA1c and FPG. BIAsp30 reduce postprandial glucose and HbA1c significantly greater than BHI30. For that reason BIAsp30 added to metformin could be optimal therapeutic option for achieving good glycaemic control in obese T2DM patients.