Improved glycaemic control is possible with the use of multiple
injections of premixed insulin. These are expensive, and not available in state
hospitals. To study the cost, patient acceptance and efficacyofa patient mixed and
administered combination of soluble and lente (biphasic) insulin administered
twice a day. Patients A cohort of 25 patients with poor glycaemic control on a
single dose of 100 units or more oflente insulin. 25 patients matched for age and
glycaemic control were used as a control. Setting The diabetic clinic of the
National Hospital Sri Lanka. A prospective study of a cohort of patients. Mean
fasting blood glucose decreased from 8.3 mmol/l (SD 3.1) to 6.9 mmol/l (SD 2.3,
p < 0.01) and mean blood glucose levels declined from 12.3 mmol/l (SD 4.1) to
10.1 mmol/l(SD 4.7, p<0.01)in the biphasic group. Total mean insulin dose fell
from 80 units (SD 12) to 61 units (SD 11) in the biphasic group, but increased in
the control group from 82 units (SD 16) to 91 units (SD 13.1). The diabetes wellbeing score in the biphasic group was 91.5 (SD 35.3), while the control group had
a score of 63.7 (SD 21.3 p < 0.01).Mean glycosylated haemoglobin (HbAlc %)
was 8.1 (SD 2.7) in the biphasic group compared to 9.2 (SD 3.3) in the control
gTpup. Patient mixed and administered biphasic insulin on a twice daily basis is
feasible, acceptable to patients, results in better glycaemic control and affords
better patient satisfaction.
Abstract :Improved glycaemic control is possible with the use of multiple
injections of premixed insulin. These are expensive, and not available in state
hospitals. To study the cost, patient acceptance and efficacyofa patient mixed and
administered combination of soluble and lente (biphasic) insulin administered
twice a day. Patients A cohort of 25 patients with poor glycaemic control on a
single dose of 100 units or more oflente insulin. 25 patients matched for age and
glycaemic control were used as a control. Setting The diabetic clinic of the
National Hospital Sri Lanka. A prospective study of a cohort of patients. Mean
fasting blood glucose decreased from 8.3 mmol/l (SD 3.1) to 6.9 mmol/l (SD 2.3,
p < 0.01) and mean blood glucose levels declined from 12.3 mmol/l (SD 4.1) to
10.1 mmol/l(SD 4.7, p<0.01)in the biphasic group. Total mean insulin dose fell
from 80 units (SD 12) to 61 units (SD 11) in the biphasic group, but increased in
the control group from 82 units (SD 16) to 91 units (SD 13.1). The diabetes wellbeing score in the biphasic group was 91.5 (SD 35.3), while the control group had
a score of 63.7 (SD 21.3 p < 0.01).Mean glycosylated haemoglobin (HbAlc %)
was 8.1 (SD 2.7) in the biphasic group compared to 9.2 (SD 3.3) in the control
gTpup. Patient mixed and administered biphasic insulin on a twice daily basis is
feasible, acceptable to patients, results in better glycaemic control and affords
better patient satisfaction.
