Self-titration of biphasic insulin aspart 30/70 improves glycaemic control and allows easy intensification in a Dutch clinical practice

AimsThis 18-month study assessed the improvement in glycaemic control and proportion of patients reaching glycated haemoglobin (HbA1c) targets with biphasic insulin aspart 30/70 (BIAsp 30) in clinical practice.MethodsType-2 diabetes patients failing on oral antidiabetic drugs (n = 90) or existing insulin regimens (n = 59) started or switched to BIAsp 30. Thiazolidinediones were stopped, metformin was continued. BIAsp 30 was given once daily (n = 41), twice daily (n = 96), or three times daily (n = 12). Patients were taught self-monitoring and self-titration using an algorithm, adding daily doses of BIAsp 30 when necessary.ResultsMean baseline HbA1c was 8.4%, weight 85.4 kg, and age 57.9 years. All patients experienced significant reductions in HbA1c (mean 1.9% ± 0.1), fasting plasma glucose (mean 2.8 mmol/l), and post-prandial glycaemia (mean 2.9 mmol/l); 91% of patients achieved HbA1c < 7% and 52% achieved HbA1c ≤ 6.5%. No major or nocturnal hypoglycaemia were reported; 15% of patients reported minor hypoglycaemia. Insulin-naïve patients gained mean 2.7 kg; patients who switched from another insulin lost weight (mean −0.6 kg).ConclusionThe results from this study from routine care suggest that BIAsp 30 may allow a large proportion of type-2 diabetes patients (90%) to improve glycaemic control and reach target HbA1c < 7%, using self-titration.