Improvement in bedtime plasma glucose level serves as a predictor of long-term blood glucose control in patients with Type 2 diabetes: A study with monotherapy of 50/50 premixed insulin analogue three times daily injection

Aim: To examine which timing of blood glucose level is more important to achieve adequate blood glucose control with insulin lispro mixture-50 (Mix 50) three times daily (TID) monotherapy. Methods: The study enrolled 35 Type 2 diabetic patients. Blood glucose levels before each meal and at bedtime were measured 2 weeks after the start of the study and were analyzed in relation to improvement in hemoglobin A1c (HbA1c) at 6-8 weeks and 6 months. Results: HbA1c improved significantly (10.1±1.6 % at baseline, 7.8±1.1 % at 6-8 weeks and 6.8±1.1 % at 6 months). Only the blood glucose level measured at bedtime correlated with improvement in HbA1c at 6-8 weeks. For the insulin-naïve patients, only bedtime plasma glucose level also had a significant correlation with improvement in HbA1c at 6 months. Conclusions: Bedtime plasma glucose level can serve as a predictor of the outcome of long-term blood glucose control during Mix 50 TID monotherapy and that bedtime plasma glucose level needs to be reduced sufficiently to achieve adequate blood glucose control.