A comparison of insulin lispro Mix25™ and human insulin 30/70 in the treatment of type 2 diabetes during Ramadan

Objective: To compare insulin lispro Mix25 and human insulin 30/70 with regard to their effect on morning and evening postprandial glucose (PPG) control, and on average daily blood-glucose (BG), in patients with Type 2 diabetes who wish to fast during Ramadan. Method: Insulin lispro Mix25 and human insulin 30/70 were compared in an open-label, multicenter, randomised, crossover study involving 151 patients. Each treatment period had a duration of 14 days during which the patients self-monitored their BG before and 2 h after the main meals on any 3 days within the last 5 days of each treatment period. Results: The 2 h PPG excursion following the main evening meal after sunset was significantly lower with insulin lispro Mix25 (3.4±2.9 mmol/l) compared with human insulin 30/70 (4.0±3.2 mmol/l, P=0.007). The evening pre-meal fasting BG values were also lower with insulin lispro Mix25 (7.1±2.2 mmol/l) versus human insulin 30/70 (7.5±2.6 mmol/l, P=0.034). The average daily BG concentration was 9.5±2.4 mmol/l during treatment with insulin lispro Mix25 versus 10.1±2.5 mmol/l with human insulin 30/70 given in identical doses (P=0.004). Conclusion: When compared with human insulin 30/70, treatment of insulin-requiring Type 2 patients with insulin lispro Mix25 during Ramadan resulted in better average daily glycaemia, and better BG control before and after the evening meal. Insulin lispro Mix25 should be considered as a therapeutic option during Ramadan.