NovoMix 30 insulin significantly improved long-term control of blood glucose in people with type 2 diabetes who were previously in poor glycemic control while taking metformin and pioglitazone alone, according to new data1 presented at the International Diabetes Federation congress in Cape Town, South Africa.
"Patients are too often treated only with OADs long after insulin therapy should have been initiated, resulting in poor glycemic control and an increased risk of serious, long-term complications," said lead investigator Phillip Raskin, MD, Professor, University of Texas, Southwestern Medical Center, USA. "In fact, our study showed that no patient with an HbA1c level above 9% could achieve the recommended goal of 7% by taking metformin and pioglitazone alone - but 60% reached that goal by adding NovoMix 30 to their treatment." Study and Findings
The findings were part of the ACTION study, which included 81 people with type 2 diabetes who were taking any two OADs but not insulin, and were in poor glycemic control, indicated by HbA1c levels of 8% or higher. HbA1c is a measure of blood haemoglobin with glucose attached to it, and is used as an indicator of glycemic control over the past few months. Leading expert groups recommend people with diabetes maintain HbA1c levels no greater than 6.5% (IDF, AACE) or less than 7%. (ADA).
At the start of the study, treatment for all participants was changed to the OADs metformin plus pioglitazone for an initial 8-week run-in period. Then participants were randomly assigned either to continue with the metformin and pioglitazone treatment only or to add NovoMix 30, administered before breakfast and supper each day, for an additional 26 weeks.
The addition of NovoMix enabled more participants to reach HbA1c treatment goals. The HbA1c targets of 6.5% or below and below 7%, respectively, were achieved by 50% (21/42) and 67% (28/42) of participants in the NovoMix+ metformin and pioglitazone group, compared to 8% (3/39) and 15% (6/39) in the metformin and pioglitazone-only group. Among participants with HbA1c levels above 9% at the start of the study, these HbA1c targets were achieved by 33% and 60% in the NovoMix+ metformin and pioglitazone group respectively, but were not achieved by any participant in the metformin and pioglitazone-only group.
NovoMix 30 is a modern premixed insulin indicated for the treatment of diabetes mellitus. As most people with diabetes do not respond to insulin in the same way, many require more than one type of insulin to control blood glucose levels. NovoMix 30 contains both rapid-acting insulin (30%) and intermediate-acting insulin (70%) in one dose, through its dual-release formula.
The rapid-acting component of NovoMix 30 begins to have an effect on glucose absorption within 0 to 10 minutes. That is why NovoMix 30 can be given right before a meal, compared to human insulin, which has to be given 30 minutes before a meal. The intermediate-acting component of NovoMix 30 has a protracted absorption and, therefore, a longer duration of action of up to 24 hours. The maximum effect occurs between 1 and 4 hours after injection.