[Advances in insulin treatment. Evaluation of isophane or lente insulin, mixed with rapid insulin and injected twice-a-day]

Abstract

When mixed with lente insulin, regular insulin undergoes a slowing down in its absorption rate, which does not occur when it is mixed with isophane insulin. However, there is not sufficient evidence to state that this phenomenon affects the quality of the metabolic control in subjects treated with two daily mixtures of regular + intermediate insulins. This parallel study compared in a 12-month follow-up the results achieved in 154 insulin-dependent diabetics (IDD) treated with extemporary mixtures injected before breakfast and dinner, with the purpose of verifying whether the mixture regular + isophane offers specific advantages compared to regular + lente. The 79 IDD who have used isophane insulin and the 75 IDD treated with lente insulin had similar personal and clinical findings. During the 12-month study, the improvement of glucose profile, the number and the severity of hypoglycaemic episodes as well as the insulin requirement resulted almost overlapping with the two treatments. In conclusion, the results of this study confirm that the mixtures of regular + isophane insulins (Actrapid HM + Protaphane HM) and regular + lente insulins (Actrapid HM + Monotard HM) give the same guaranties of safety and efficacy, that the former shows a more rapid absorption rate and, finally, indicate that the ratio 30:70 between regular and intermediate insulins is that more frequently used.