Practical approaches to insulin therapy for type 2 diabetes mellitus with premixed insulin analogues

Premixed insulin analogues have a more physiologic time-action profile, can be administered closer to mealtime, and produce greater reductions in the magnitude of postprandial glucose excursions than human insulin 70/30. Despite these advantages, no consistent differences in HbA1c reduction or the incidence of hypoglycemia versus human insulin 70/30 have been found in most short-term trials. Although there is an increased risk of minor hypoglycemia, patients using premixed insulin analogues twice daily are more likely to reach HbA1c goals than those using only insulin glargine once daily. Further studies are necessary to examine whether these advantages improve patient outcomes in clinical practice.