PMID- 18643839
OWN - NLM
STAT- MEDLINE
DCOM- 20090805
LR  - 20221207
IS  - 1463-1326 (Electronic)
IS  - 1462-8902 (Linking)
VI  - 11
IP  - 1
DP  - 2009 Jan
TI  - Comparison of insulin analogue regimens in people with type 2 diabetes mellitus 
      in the PREFER Study: a randomized controlled trial.
PG  - 45-52
LID - 10.1111/j.1463-1326.2008.00915.x [doi]
AB  - AIMS: Insulin analogues are widely used but few data exist comparing different 
      analogue regimens. We compared two such regimens in type 2 diabetes mellitus 
      (T2DM) uncontrolled by oral antidiabetic agents (OADs) with or without basal 
      insulin. METHODS: In a 26-week multinational, multicentre, randomized 
      treat-to-target trial, OADs were discontinued and subjects randomized to analogue 
      basal-bolus therapy (insulin detemir once daily and insulin aspart mealtimes) or 
      biphasic insulin aspart 30 (30% rapid-acting insulin aspart), twice daily. 
      Insulin was titrated to targets for fasting, predinner and postprandial plasma 
      glucose (PG), as appropriate. RESULTS: Of 719 subjects, 92% completed the study; 
      58% achieved haemoglobin fraction A(1c) (HbA(1c)) < or =7.0%, with reductions of 
      1.56% (to 6.96%) with basal-bolus therapy and 1.23% (to 7.17%) with biphasic 
      insulin aspart. Reduction with basal-bolus therapy was superior in the overall 
      population by 0.23% (p = 0.0052), with no difference between regimens in 
      insulin-naive patients. Major hypoglycaemia occurred in five basal-bolus patients 
      (0.9%) and in no patients with biphasic insulin aspart. Incidence of minor 
      hypoglycaemia was similar in both groups. All insulin doses increased during 
      titration, with increase in lunchtime insulin aspart dose and equal distribution 
      of breakfast and dinner biphasic insulin aspart doses. Insulin detemir remained 
      once daily in 87% of patients. CONCLUSIONS: Modern insulin analogue regimens, 
      adjusted to PG targets, enable a majority of people with T2DM to reach HbA(1c)< 
      or =7.0% after failure of OADs and OAD-basal insulin therapy. Insulin-treated 
      patients may benefit more from transfer to analogue basal-bolus therapy, while 
      insulin-naive individuals benefit equally well from the more convenient biphasic 
      analogue regimen.
FAU - Liebl, A
AU  - Liebl A
AD  - Center for Diabetes and Metabolism, Fachklinik Bad Heilbrunn, Germany.
FAU - Prager, R
AU  - Prager R
FAU - Binz, K
AU  - Binz K
FAU - Kaiser, M
AU  - Kaiser M
FAU - Bergenstal, R
AU  - Bergenstal R
FAU - Gallwitz, B
AU  - Gallwitz B
CN  - PREFER Study Group
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20080717
PL  - England
TA  - Diabetes Obes Metab
JT  - Diabetes, obesity & metabolism
JID - 100883645
RN  - 0 (Biphasic Insulins)
RN  - 0 (Blood Glucose)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Insulin)
RN  - 0 (Insulin, Long-Acting)
RN  - 0 (insulin aspart, insulin aspart protamine drug combination 30:70)
RN  - 4FT78T86XV (Insulin Detemir)
RN  - 53027-39-7 (Insulin, Isophane)
RN  - D933668QVX (Insulin Aspart)
SB  - IM
MH  - Aged
MH  - Biphasic Insulins
MH  - Blood Glucose/metabolism
MH  - Diabetes Mellitus, Type 2/blood/*drug therapy
MH  - Drug Administration Schedule
MH  - Drug Therapy, Combination
MH  - Female
MH  - Glycated Hemoglobin/metabolism
MH  - Humans
MH  - Hypoglycemia/chemically induced
MH  - Hypoglycemic Agents/administration & dosage/adverse effects/*therapeutic use
MH  - Insulin/administration & dosage/adverse effects/*analogs & 
      derivatives/therapeutic use
MH  - Insulin Aspart
MH  - Insulin Detemir
MH  - Insulin, Isophane
MH  - Insulin, Long-Acting
MH  - Male
MH  - Middle Aged
MH  - Treatment Outcome
MH  - Weight Gain
EDAT- 2008/07/23 09:00
MHDA- 2009/08/06 09:00
CRDT- 2008/07/23 09:00
PHST- 2008/07/23 09:00 [pubmed]
PHST- 2009/08/06 09:00 [medline]
PHST- 2008/07/23 09:00 [entrez]
AID - DOM915 [pii]
AID - 10.1111/j.1463-1326.2008.00915.x [doi]
PST - ppublish
SO  - Diabetes Obes Metab. 2009 Jan;11(1):45-52. doi: 10.1111/j.1463-1326.2008.00915.x. 
      Epub 2008 Jul 17.