Efficacy and Acceptance of Two Intensified Conventional Insulin Therapy Regimens: a Long‐term Cross‐over Comparison

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Abstract
The efficacy and acceptability of multiple daily insulin injections (three preprandial injections of short‐acting insulin (NovoPen) plus once daily extended‐acting insulin) were compared with those of twice daily injections of short‐ and intermediate‐acting insulin. Sixteen Type 1 diabetic patients participated in a cross‐over study (6‐month treatment periods). Total areas under 24‐h plasma free insulin curves, assessed at the end of each study period, were not significantly different, but a greater area under this curve was found for the pen‐injector regimen from 1200 to 1600 h (150 ± 15 (SE) vs 106 ± 7 mU l−1 h, p < 0.01). Home blood glucose profiles showed significantly lower values with pen‐injector therapy after lunch (7.1 ± 0.6 vs 8.4 ± 0.4 mmol l−1, p = 0.05) and before and after dinner (6.4 ± 0.6 vs 8.8 ± 0.5 mmol l−1, p < 0.005, and 7.5 ± 0.7 vs 9.4 ± 1.1 mmol l−1, p < 0.05). Mean daily blood glucose concentration was also lower (7.1 ± 0.4 vs 8.2 ± 0.5 mmol l−1, p < 0.05). HbA1, fructosamine, hypoglycaemic reactions, and body weight were not significantly different. Thirteen patients decided to continue with pen‐injector therapy at the end of the study.