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Modified Insulin Most Effective For Controlling Post-Meal Blood Sugar Levels
Date:9/15/2008

ans carefully with their physician."

Pre-mixed insulin analogues are a modified form of conventional pre-mixed human insulin. AHRQ's report compared pre-mixed insulin analogues with conventional pre-mixed human insulin, oral diabetes drugs, and two other kinds of insulin analogues -- long-acting (or "basal") analogues, and rapid-acting (or "bolus") analogues.

Although non-insulin oral medications are used as a first-line treatment for patients with type 2 diabetes, insulin is frequently required at some stage during the course of the disease. Under such circumstances, some patients are controlled with long-acting insulin alone while others need a combination of long-acting and rapid-acting insulins to control blood sugar levels after meals, especially meals with high sugar content.

About 28 percent use some form of insulin to control blood sugar levels and limit complication risks from type 2 diabetes. Pre-mixed insulin analogues, approved in the U.S. in 2003, are produced by genetically modifying selected proteins of human insulin. Insulin analogues were developed as an alternative to conventional pre-mixed human insulin to provide tighter control of blood sugar levels.

Additional findings in AHRQ's new report:

-- Long-acting insulin analogues appear to be more effective than pre-mixed insulin analogues in lowering fasting blood sugar levels.

-- Pre-mixed insulin analogues are better than long-acting analogues alone in lowering blood sugar levels after a meal with high sugar content.

-- Pre-mixed insulin analogues are more effective than long-acting analogues in lowering Hemoglobin A1c, which is a highly reliable indicator of chronic high blood sugar.

-- Pre-mixed insulin analogues are more effective than non-insulin antidiabetic medications in lowering fasting blood sugar levels.

-- Pre-mixed insulin analogues are more likely than long-acting analogues to be associated with hypoglycemia (blood sugar so
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SOURCE Agency for Healthcare Research & Quality
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