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Expert Opinion: Patient Selection for Premixed Insulin Formulations in Diabetes Care

Kalra S 1 , Czupryniak L 2 , Kilov G 3 , Lamptey R 4 , Kumar A 5 , Unnikrishnan AG 6 Show all authors , Boudiba A 7 , Abid M 8 , Akanov ZA 9 , Latheef A 10 , Araz M 11 , Audehm R 3 , Bahendeka S 12 , Balde N 13 , Chaudhary S 14 , Deerochanawong C 15 , Fasanmade O 16 , Iraqi H 17 , Latt TS 18 , Mbanya JC 19 , Rodriguez-Saldana J 20 , Hyun KS 21 , Latif ZA 22 , Lushchyk M 23 , Megallaa M 24 , Naseri MW 25 , Bay NQ 26 , Ramaiya K 27 , Randeree H 28 , Raza SA 29 , Shaikh K 30 , Shrestha D 31 , Sobngwi E 19 , Somasundaram N 32 , Sukor N 33 , Tan R 34

Affiliations 

  • 1 Department of Endocrinology, Bharti Hospital Karnal, Karnal, India. [email protected]
  • 2 Department of Diabetology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
  • 3 Department of General Practice, University of Melbourne, Melbourne, Australia
  • 4 Department of Family Medicine, Korle Bu Teaching Hospital, University of Ghana, School of Public Health Ghana, Accra, Ghana
  • 5 Department of Diabetology, Diabetes Care and Research Centre, Patna, India
  • 6 Department of Endocrinology, Chellaram Diabetes Institute, Pune, India
  • 7 Department of Endocrinology and Diabetology, University Hospital Center Mustapha, Algiers, Algeria
  • 8 Department of Endocrinology and Diabetology, Hedi Chaker University Hospital, Sfax, Tunisia
  • 9 Center of Diabetes, Clinic of Internal Diseases, Asfendyarov Kazakh National Medical University, Almaty, Republic of Kazakhstan
  • 10 Department of Medicine, Indra Gandhi Hospital, Male, Maldives
  • 11 Department of Endocrinology and Metabolism, Gaziantep University Hospital, Gaziantep, Turkey
  • 12 Department of Diabetology, St. Francis Hospital, Nsambya, Uganda
  • 13 Department of Endocrinology, Donka Conakry University Hospital, Conakry, Guinea
  • 14 Department of Endocrinology, NMC Speciality Hospital, Dubai, United Arab Emirates
  • 15 Diabetes and Endocrinology Unit, College of Medicine, Rangsit University, Rajavithi Hospital, Bangkok, Thailand
  • 16 Department of Endocrinology, Lagos University Teaching Hospital, Lagos, Nigeria
  • 17 Department of Endocrinology and Diabetology, Faculty of Medicine and Pharmacie, Mohammed V University, Rabat, Morocco
  • 18 Myanmar Diabetes Association, Yangon, Myanmar
  • 19 Department of Internal Medicine, Central Hospital, Yaoundé, Cameroon
  • 20 Multidisciplinario de Diabetes Centre, Mexico City, Mexico
  • 21 Department of Endocrinology, St Vincent's Hospital, Catholic University, Suwon, South Korea
  • 22 BIRDEM, Dhaka, Bangladesh
  • 23 Department of Endocrinology, Belarusian Medical Academy of Postgraduate Education, Minsk, Belarus
  • 24 Department of Diabetes and Metabolism, Alexandria University, Alexandria, Egypt
  • 25 Department of Internal Medicine, Division of Endocrinology, Metabolism and Diabetes, Kabul University of Medical Sciences, Kabul, Afghanistan
  • 26 Department of Endocrinology, Bach Mai Hospital, Hanoi, Vietnam
  • 27 Department of Diabetology, Shree Hindu Mandal Hospital, Dar es Salaam, Tanzania
  • 28 Department of Endocrinology, Parklands Medical Centre, Durban, South Africa
  • 29 Department of Endocrinology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
  • 30 Department of Endocrinology, Royal Oman Police Hospital, Muscat, Oman
  • 31 Department of Endocrinology, Norvic International Hospital, Kathmandu, Nepal
  • 32 Department of Diabetes and Endocrinology, National Hospital of Sri Lanka, Colombo, Sri Lanka
  • 33 Endocrine Unit, Department of Medicine, National University of Malaysia Medical Center, Kuala Lumpur, Malaysia
  • 34 Institute for Studies on Diabetes Foundation Inc, Marikina City, Philippines
Diabetes Ther, 2018 Dec;9(6):2185-2199.
PMID: 30390228 DOI: 10.1007/s13300-018-0521-2

Abstract

Premixed insulins are an important tool for glycemic control in persons with diabetes. Equally important in diabetes care is the selection of the most appropriate insulin regimen for a particular individual at a specific time. Currently, the choice of insulin regimens for initiation or intensification of therapy is a subjective decision. In this article, we share insights, which will help in rational and objective selection of premixed formulations for initiation and intensification of insulin therapy. The glycemic status and its variations in a person help to identify the most appropriate insulin regimen and formulation for him or her. The evolution of objective glucometric indices has enabled better glycemic monitoring of individuals with diabetes. Management of diabetes has evolved from a 'glucocentric' approach to a 'patient-centered' approach; patient characteristics, needs, and preferences should be evaluated when considering premixed insulin for treatment of diabetes.Funding: Novo Nordisk, India.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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