Comparison of HbAlc in Chinese patients with type 1 or type 2 diabetes randomized to twice daily insulin lispro low mix 25 or twice daily human insulin mix 30/70

• Published in: Chinese medical journal Vol. 122; no. 21; pp. 2540 - 2546
• Main Author: LI Yan LI Qiang LI Cheng-jiang WANG Chang-jiang ZHENG Yi-man Maher Issa ZHANG Jia
• Format: Journal Article
• Language: English
• Published: Department of Endocrinology,Second Affiliated Hospital of Sun Yat-sen University,Guangzhou,Guangdong 510102,China%Department of Endocrinology,Second Affiliated Hospital of Harbin Medical University,Harbin,Heilongjiang 150086,China%Department of Endocrinology,First Affiliated Hospital of Medical College of Zhejiang University,Hangzhou,Zhejiang 310003,China%Department of Endocrinology,First Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230022,China%Department of Medicine,Eli Lilly China,Shanghai,200021,China%Department of Medicine,Eli Lilly Canada Inc.,Toronto,3650,Canada 2009
• Subjects: Chinese patient; diabetes mellitus; hemoglobin Al c protein; insulin; human
• ISSN: 0366-6999; 2542-5641
• DOI: 10.3760/cma.j.issn.0366-6999.2009.21.004

Background Glycemic control prevents onset and progression of diabetes-related long-term complications. The objective of this study was to demonstrate that twice daily insulin lispro low mix 25 is noninferior to twice daily human insulin mix 30/70 in achieving glycemic control as measured by hemoglobin Alc （HbAlc）, from baseline to endpoint, in patients with type 1 or 2 diabetes. Methods In this phase IV, crossover, open-label, multicenter study, 117 Chinese patients with diabetes were randomly assigned to one of two treatment sequence groups. One group received 12-week treatment with twice daily human insulin mix 30/70 followed by 12-week treatment with twice daily insulin lispro low mix 25, while the other group received the reverse treatment sequence. HbAlc, baseline-to-endpoint change in HbAlc, proportion of patients achieving target HbAlc ≤ 7% and 〈 6.5%, fasting blood glucose, and daily insulin doses were measured for each period. Safety and tolerability were also assessed. Results A statistically significant reduction （P≤0.0001） of HbAlc was achieved after each treatment （human insulin mix 30/70： mean HbA1c=7.91% （95% CI： 7,67%, 8.15%）; insulin lispro low mix 25： mean HbA1c=7.96% （95% CI： 7.72%, 8.20%））. The 95% Cl （-0.20, 0.10） of the difference between the two treatments satisfied the prespecified noninferiority margin of 0.3% （lower limit of 95% CI 〉 -0.3%）. No statistically significant differences between treatments were observed for any of the secondary efficacy measures. The incidence of treatment-emergent adverse events and hypoglycemia between the two treatments and treatment sequence groups was similar. Three serious adverse events were reported （human insulin mix 30/70 group： 2 patients （1.7%, hypoglycemic coma and cardiac failure）; insulin lispro low mix 25 group： 1 patient （0.9%, stroke））. All serious adverse events were resolved and no patients died during the study. Conclusion The results support noninferiority of twice daily insulin lispro low mix 25 versus twice daily human insulin mix 30/70 in HbAlc control in Chinese patients with type 1 or 2 diabetes.