Use of a premixed insulin regimen (Novolin 70/30) to replace self-mixed insulin regimens.
The efficacy and safety of transferring 76 patients with poorly controlled type II diabetes mellitus from various self-mixed human insulin regimens to a premixed insulin regimen (Novolin 70/30, 70% NPH and 30% Regular insulin, semisynthetic) were evaluated in a 24-week, multicenter, open-label study. During the initial 12-week run-in period, the patients received twice-daily doses of NPH and Regular human insulin mixed in ratios of 60/40, 80/20, 90/10, or NPH alone, as recommended by their physicians. Subsequently, these patients were transferred to a regimen of Novolin 70/30 twice daily for an additional 12 weeks. In most cases, the transfer was made on a dose-for-dose basis. Following the transfer from self-mixed to premixed insulin, the mean glycated hemoglobin fell from 9.3% to 8.7% at 6 weeks (P < 0.001) and to 8.5% at 12 weeks (P < 0.001). This improved glycemic control was not accompanied by an increase in the frequency or severity of hypoglycemic episodes. It is concluded that patients with type II diabetes mellitus who are poorly controlled on a wide range of self-mixed insulin ratios can be safely transferred, often in a dose-for-dose fashion, to a more convenient 70/30 premixed regimen.