European Journal of Biomedical and Pharmaceutical Sciences

IS THERE IS A PLACE FOR PREMIXED INSULIN IN TYPE 1 DIABETES MELLITUS?

Abbas Ali Mansour, MD, FRCP, FACE.*, Ali Hussein Ali Alhamza, MD., Ammar Mohamd Saead Almomin, MD, Ibrahim Abbood Zaboon, MD, Ahmed Jaafer Hindi Al-Ali, MD

ABSTRACT

Background: The management of patients with type 1 diabetes mellitus is challenging for most doctors because its involve multi-disciplinary team one of it is insulin availability, but it's not the only problem. The aim of this study was to see the role of premixed human insulin in a cohort of type 1 diabetes from Basrah, Southern Iraq. Methods: a prospective 6 months study of patients with type 1 diabetes mellitus enrolled from Al-Faiha Specialized Diabetes, Endocrine, and Metabolism Center (FDEMC). Group one with premixed human insulin (70/30) given in two equal divided doses before breakfast and before dinner. Group two given insulin as modified basal bolus. The modified basal bolus includes two regular human insulin before breakfast and lunch with premixed human insulin (70/30) at dinner or twice premixed and regular human insulin at lunch. The third group given insulin as a basal bolus. Results: In all age groups of type 1 diabetes premixed group achieved the best results, but not reached statistical significance. Toddlers and preschoolers have the lowest figures for achieving targets of glycemia though no statistically significant differences between the different age group regarding the achievement of target HbA1c.Only 72 out of 566 patients (12.7%) of the whole cohort achieved the target HbA1c by six months. Conclusion: our patients whether they are using premixed insulin twice or modified basal bolus thrice with premixed or multiple four injections of basal bolus insulin regimen achieve no significant difference in glycemic control. One of the explanations of the results may be the absence of diabetic educator, carbohydrate counting, and social interventions.

Keywords: type 1 diabetes mellitus, premixed insulin, glycemic control.