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Topic: Biphasic insulin

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	Biphasic insulin aspart as an insulin...
		Insulin doses were titrated according to blood glucose profile results, with fasting and preprandial targets of 5—8 mmol/l (90—144 mg/dl).
		In this study, a unique analogue combining rapid-acting insulin aspart with a protamine-crystallized insulin aspart was at least as good as NPH in controlling overall glycemia (HbA1c) and postprandial glycemic levels after the two meals with which it was taken.
		In other words, taking individuals on NPH insulin and treating them with NPH insulin in doses that ‘reflected their pre-trial requirement’ (I interpret this to mean starting at a similar dose) does not improve their control.
	www.d4pro.com /IDM/site/biphasic_insulin_aspart_as_an_insulin___.htm (981 words)

	Premixed (biphasic) insulin...
		Biphasic insulin aspart, NovoMix® 30 (or NovoLog® Mix70/30 in some countries), comprises 30% insulin aspart (NovoLog® or NovoRapid® in some countries) and 70% protamine-crystallized insulin aspart (which has a very similar action to that of isophane insulin).
		An overnight insulin infusion was used to obtain blood glucose levels of approximately 6.8 mmol/l prior to a standard breakfast.
		With premixed insulins, only the total dose, not the individual components, can be altered (unless a change to a mixture with different proportions is made.) It is thus my view that premixed insulin represents a compromise to intensive insulin therapy in type 1 diabetes.
	www.medforum.nl /idm/premixed_(biphasic)_insulin___.htm (953 words)

	MD Net Guide (Site not responding. Last check: 2007-10-24)
		In the study there was also a similar relatively easy algorithm that was adjusted twice daily for the biphasic insulin aspart; you change the morning insulin dose based on the pre-supper blood glucose level, and you change the evening dose based on the pre-breakfast blood sugar.
		There was more insulin used in the biphasic insulin aspart group, because there were two times when one might have to adjust the insulin.
		What I really concluded from this study was that biphasic insulin aspart twice a day, when you have someone on tablets who needs to be on insulin, is another choice that you can take in addition to just starting someone on a single injection at bedtime.
	www.mdnetguide.com /departments/july_aug2004/interview.htm (1506 words)

	Insulin therapy in type 2 diabetes
		Both papers report on the use of insulin regimens in type 2 diabetic patients who are not optimally controlled with oral agents, in one case, and either oral agents alone or in combination with a single injection of NPH insulin, in the other.
		These authors conclude that the use of biphasic insulin aspart offers a slight but significant advantage in lowering HbA1c levels and mean postprandial blood glucose values compared with the use of twice-daily NPH insulin.
		Comparing the use of metformin with once-daily injections of biphasic insulin aspart, biphasic human insulin or NPH insulin, these authors reported that all three regimens led to similar lowering of HbA1c levels, whilst fasting blood glucose levels were lowered most by the use of once-nightly NPH insulin (Fig.
	www.d4pro.com /idm/site/insulin_therapy_in_type_2_diabetes.htm (1078 words)

	[Frontiers in Bioscience 2, d160-172, March 15, 1997]
		Sustained, short-term (1 hour or less) glucose stimulation of rat islets results in a biphasic insulin secretory response (Figure 1) characterized by a transient first phase of release and a slowly rising and sustained second phase response that is, depending on the preparation and the glucose level, 30-60 fold greater than prestimulatory release rates (4-8).
		While glucose-dependent insulin secretion clearly depends on extracellular calcium influx into the ß-cell (40-42), this event alone is insufficient to explain the large and rising biphasic insulin secretory response which occurs in response to the hexose.
		Since insulin resistance can be acquired as a consequence of hyperinsulinemia(97-99), changes at the level of ß-cell signal transduction systems which amplify their stimulatory effect on insulin release, may be primary etiologic components in the odyssey to obesity(100).
	www.bioscience.org /1997/v2/d/zawalic1/htmls/160-172.htm (7246 words)

	Data Sheet
		The blood glucose lowering effect of insulin is due to the facilitated uptake of glucose following binding of insulin to receptors on muscle and fat cells and to the simultaneous inhibition of glucose output from the liver.
		Human insulin is reported to be degraded by insulin protease or insulin-degrading enzymes and possibly protein disulfide isomerase.
		Insulin suspensions are not to be used in insulin infusion pumps.
	www.medsafe.govt.nz /Profs/Datasheet/PenmixMixtardProtaphaneinj.htm (2129 words)

	First-phase insulin secretion: does it exist in real life? Considerations on shape and function -- Caumo and Luzi 287 ...
		Of note is that the insulin response observed after food ingestion cannot be accounted for solely by the associated changes in the blood glucose level but also depends on other factors, such as the presence of free fatty acids and other secretagogues in the meal, the neurally activated cephalic phase, and gastrointestinal hormones.
		of the first-phase insulin release is the consequence of the
		insulin response to the hyperglycemic clamp and a model-based
	ajpendo.physiology.org /cgi/content/full/287/3/E371 (8035 words)

	Diabetes In Control Dot Com. The weekly newsletter for medical professionals in Diabetes care.
		Single daily dose injections of either NPH insulin, biphasic insulin aspart, or biphasic human insulin in combination with metformin are equally effective strategies for starting type 2 diabetes patients on insulin therapy.
		However, many type 2 diabetes patients eat a large portion of their calories at dinner, and recent studies have suggested that biphasic insulin preparations given before dinner may also be effective in once-daily injection routines.
		Glycosylated hemoglobin levels decreased by 1.3%, 1.2%, and 1.1% with biphasic insulin aspart, NPH insulin, and biphasic human insulin, respectively, and fasting plasma glucose decreased from baseline by 31%, 37%, and 28%.
	www.diabetesincontrol.com /issue182/item12.shtml (470 words)

	Clinical Trial: A Comparison of Pharmacodynamics and Pharmacokinetics of Insulin Aspart, Biphasic Insulin Aspart 30, 50 ...
		A Comparison of Pharmacodynamics and Pharmacokinetics of Insulin Aspart, Biphasic Insulin Aspart 30, 50 and 70.
		The objective is to describe pharmacodynamic (PD) and pharmacokinetic (PK) profiles of Insulin Aspart (IAsp), Biphasic Insulin Aspart (BIAsp) 30, 50 and 70 for a period of 12 hours following a standard test meal on four days respectively in subjects with type 1 diabetes.
		Jacobsen LV, Sogaard B, Riis A. Pharmacokinetics and pharmacodynamics of a premixed formulation of soluble and protamine-retarded insulin aspart.
	www.clinicaltrials.gov /ct/show/NCT00283218 (716 words)

	The Cell Physiology of Biphasic Insulin Secretion -- Rorsman et al. 15 (2): 72 -- Physiology
		Whereas first phase insulin secretion can be envisaged to reflect exocytosis of a readily releasable pool of granules (RRP), second phase is due to release of granules that may be located further away from release site(s) (reserve pool).
		of secretory granules underlies the biphasic insulin release
		A: insulin secretion when glucose concentration is elevated to 18 mM in healthy individuals and in patients with mild manifest type II diabetes.
	physiologyonline.physiology.org /cgi/content/full/15/2/72 (3723 words)

	Twice-daily biphasic insulin aspart 30 plus metformin compared with once-daily insulin glargine in combination with ...
		The aim of the study was to compare the efficacy and safety of two insulin analogue regimens in 255 patients (131 male; mean±SD age, 61.2±9.1 yrs) with type 2 diabetes.
		In this randomised, open-label parallel study, twice-daily biphasic insulin aspart 30 plus metformin (30% soluble and 70% protaminated insulin aspart; BIAsp 30+ met; n=128) was compared with once-daily insulin glargine combined with once-daily oral glimepiride (glarg + glim; n=127) over 26 weeks.
		Median total daily insulin doses were 25 U BIAsp 30 and 28 U glargine; median daily doses for the oral agents were 2000 mg met and 4.0 mg glim.
	www.endocrine-abstracts.org /ea/0010/ea0010oc8.htm (377 words)

	Study on Dual-Acting Insulin Analog Novolog(R) Mix 70/30 Suggests Alternate Approach to Treating Type 2 Diabetes< (Site not responding. Last check: 2007-10-24)
		None of the participants had previously been on insulin therapy, and all had inadequate glycemic control (control of blood glucose levels) based on A1C levels of 7.5 percent or higher (four to six percent was defined in the study as "normal," and is considered the normal range in people without diabetes(2)).
		By the end of the trial, all three treatments reduced A1C levels compared to baseline, by 1.3 percent in the biphasic insulin aspart group, 1.2 percent in the NPH insulin group, and 1.1 percent in the biphasic human insulin group.
		Compared to other insulin delivery devices that have to be manually loaded with insulin cartridges, prefilled pens are ready to use, eliminating the step of loading insulin into the delivery device.
	quickstart.clari.net /qs_se/webnews/wed/bf/W059713.RLgx_DNB.html (1103 words)

	Clinical Trial: Effect of Biphasic Insulin Compared to Biphasic Insulin Combined With Insulin Aspart, With or Without ...
		The objective of the study is to compare glycemic control of Biphasic insulin Aspart 30 twice daily with Biphasic insulin Aspart 30 twice daily plus Insulin Aspart, both insulin treatments with or without metformin, in subjects with type 2 diabetes, previously treated with Biphasic Human Insulin 30/70.
		Official Title: Comparison of Glycemic Control of Biphasic Insulin Aspart 30 Twice Daily With Biphasic Insulin Aspart 30 Twice Daily Plus Lunchtime Injection of Insulin Aspart, in Combination With or Without Metformin (for Both Treatment Groups) in Subjects With Type 2 Diabetes.
		Current treatment with Biphasic Human Insulin 30/70 twice daily alone or in combination with any oral hypoglycaemic agent for at least 3 months prior to entering the trial.
	www.clinicaltrials.gov /ct/show/NCT00282451 (341 words)

	Insulin Initiation With NovoMix 30 (Biphasic Insulin Aspart) Yields Significantly Greater Blood Glucose Reductions than ... (Site not responding. Last check: 2007-10-24)
		The trial examined and assessed starting insulin options that are currently available for GPs to help control glucose levels in their diabetes patients.
		There is now a growing body of evidence showing that starting patients on biphasic insulin aspart may be a more effective option than glargine, and can help GPs to achieve glycaemic control in their patients," said Prof.
		Jain R, et al: Efficacy of biphasic insulin aspart 70/30 in patients with T2DM not achieving glycemic targets on OADs with/without basal insulin therapy.
	www.pslgroup.com /dg/254ABE.htm (750 words)

	ADA: Biphasic insulin aspart 70/30 Achieves Superior Glycemic Control in Head-to-Head With Insulin Glargine (Site not responding. Last check: 2007-10-24)
		Supper biphasic insulin aspart dosing and bedtime glargine were titrated based on fasting blood glucose readings over the previous 3 days.
		At end point, mean A1C value in the biphasic insulin aspart cohort was lower than in the insulin glargine cohort.
		At 28 weeks, 71% of the completers using biphasic insulin aspart had reached the target A1C levels of 7.0 %, as compared to 45% of the insulin glargine subjects.
	www.pslgroup.com /dg/2445ba.htm (530 words)

	Signals and Pools Underlying Biphasic Insulin Secretion -- Henquin et al. 51 (Supplement 1): 60 -- Diabetes
		Insulin secretion was measured with groups of 25 islets preincubated with or without thapsigargin, and without fura PE3.
		the magnitude of the insulin response decreased with the repetition
		Nesher R, Cerasi E: Biphasic insulin release as the expression of combined inhibitory and potentiating effects of glucose.
	diabetes.diabetesjournals.org /cgi/content/full/51/suppl_1/S60 (4718 words)

	children with DIABETES - Ask the Diabetes Team
		The term 'biphasic insulin' conventionally applies to a mixture of two insulins that have different durations, the commonest being a mixture of regular human insulin and NPH in the ratio of 3:7, There are ongoing attempts though to improve the effect of these mixtures by using substituted insulins i.e.
		insulins like Lispro where the sequence of amino acids in one or both chains of the insulin molecule have been changed.
		I imagine that the Biphasic Insulin in your daughter's trial is something like this.
	www.childrenwithdiabetes.com /dteam/2000-03/d_0d_4o3.htm (271 words)

	children with DIABETES - Diabetes Dictionary: B
		Beta cells make and release insulin, a hormone that controls the level of glucose (sugar) in the blood.
		A type of insulin that is a mixture of intermediate- and fast-acting insulin.
		An extra boost of insulin given to cover expected rise in blood glucose (sugar) such as the rise that occurs after eating.
	www.childrenwithdiabetes.com /dictionary/b.htm (749 words)

	Importance of Nonionic Signals for Glucose-Induced Biphasic Insulin Secretion -- Aizawa et al. 51 (Supplement 1): 96 -- ...
		Biphasic insulin release by the islet ß-cell upon
		is clearly biphasic, as it is in the perfused pancreas.
		it was speculated that the glucose-induced biphasic response
	diabetes.diabetesjournals.org /cgi/content/full/51/suppl_1/S96 (2088 words)

	A retrospective audit of biphasic insulin lispro - Audit Diabetes and Primary Care - Find Articles
		1 An audit was carried out to assess the effectiveness of biphasic insulin lispro (Humalog Mix 25) after a year of use and the degree of patient satisfaction.
		The discovery of insulin, approximately eight decades ago by the renowned Banting, Best, Collip and Macleod, is well documented (Bliss, 1982) and does not appear, as yet, to have been surpassed as a life-saving phenomenon.
		They have developed insulin from a soup-like preparation that led to pain and allergic reaction at the injection site, to insulin so pure that few people with diabetes today have significant adverse clinical reactions.
	www.findarticles.com /p/articles/mi_m0MDP/is_4_5/ai_112129958 (371 words)

	eMedicine News
		NEW YORK (Reuters Health) - In patients with type 2 diabetes poorly controlled on oral antidiabetic drugs, the use of biphasic insulin aspart (70/30 BIAsp) appears to be more effective than long-acting insulin glargine in achieving glycemic control, Dr. Philip Raskin and colleagues report in the February issue of Diabetes Care.
		BIAsp 70/30 (NovoLog Mix 70/30, Novo Nordisk) contains 30% soluble insulin aspart and 70% insulin aspart crystallized with protamine, which is used to control both fasting and postprandial hyperglycemia, Dr. Raskin, of the University of Texas, Dallas, and his colleagues point out.
		Insulin doses were titrated to achieve target fasting plasma glucose levels.
	www.emedicine.com /cgi-bin/foxweb.exe/newsitem@/em/news?name=20050221clin004.xml (436 words)

	Transduction of MIN6 beta Cells with TAT-Syntaxin SNARE Motif Inhibits Insulin Exocytosis in Biphasic Insulin Release ...
		Transduction of MIN6 beta Cells with TAT-Syntaxin SNARE Motif Inhibits Insulin Exocytosis in Biphasic Insulin Release in a Distinct Mechanism Analyzed by Evanescent Wave Microscopy -- Ohara-Imaizumi et al.
		The amounts of insulin released into the medium and acid-alcohol extracts were measured by enzyme-linked immunosorbent assay.
		Insulin release at each point is expressed as the percentage of total cellular content.
	www.jbc.org /cgi/content/full/277/52/50805 (5794 words)

	CaV2.3 channel and PKC{lambda}: new players in insulin secretion -- Yang and Berggren 115 (1): 16 -- Journal of ...
		Glucose-stimulated insulin secretion is characterized by a rapid first phase of insulin release for about 10 minutes, followed by a nadir, and subsequently a gradually increasing second phase reaching a plateau after 25 to 30 minutes (inset).
		Protein kinase C modulates the insulin secretory process by maintaining a proper function of the ß-cell voltage-activated Ca channels.
		Possible involvement of atypical protein kinase C (PKC) in glucose-sensitive expression of the human insulin gene: DNA-binding activity and transcriptional activity of pancreatic and duodenal homeobox gene-1 (PDX-1) are enhanced via calphostin C-sensitive but phorbol 12-myristate 13-acetate (PMA) and Go 6976-insensitive pathway.
	www.jci.org /cgi/content/full/115/1/16 (2561 words)

	Improved Postprandial Glycemic Control With Biphasic Insulin Aspart Relative to Biphasic Insulin Lispro and Biphasic ...
		Improved Postprandial Glycemic Control With Biphasic Insulin Aspart Relative to Biphasic Insulin Lispro and Biphasic Human Insulin in Patients With Type 2 Diabetes -- Hermansen et al.
		Improved Postprandial Glycemic Control With Biphasic Insulin Aspart Relative to Biphasic Insulin Lispro and Biphasic Human Insulin in Patients With Type 2 Diabetes
		with that of biphasic insulin lispro 25 (Mix25: 25% lispro,
	care.diabetesjournals.org /cgi/content/abstract/25/5/883 (410 words)

	News - Metformin Safe and Effective Combined with Single Daily Injections of NPH Insulin, Biphasic Insulin Aspart, or ...
		Single daily dose injections of either NPH insulin, biphasic insulin aspart, or biphasic human insulin in combination with metformin are equally effective strategies for starting type 2 diabetes patients on insulin therapy, according to new research.
		Each of the insulin combination regimens effectively improved glycaemic control, reports Dr. Kilo, and no significant differences were detected between the treatments.
		Glycosylated haemoglobin levels decreased by 1.3%, 1.2%, and 1.1% with biphasic insulin aspart, NPH insulin, and biphasic human insulin, respectively, and fasting plasma glucose decreased from baseline by 31%, 37%, and 28%.
	www.docguide.com /news/content.nsf/news/8525697700573E1885256DD00039FD37?OpenDocument&c=Diabetes&count=10 (675 words)

	News - ADA: Biphasic Insulin Aspart 70/30 Achieves Superior Glycemic Control in Head-to-Head Study With Insulin Glargine
		The biphasic insulin aspart dose at supper and the bedtime glargine dose were titrated based on fasting blood glucose readings over the previous 3 days.
		At end point, mean HbA1c value in the biphasic insulin aspart cohort was lower than in the insulin glargine cohort.
		At 28 weeks, 71% of the completers using biphasic insulin aspart had reached the target HbA1c level of 7.0 %, as compared to 45% of the insulin glargine subjects.
	www.docguide.com /news/content.nsf/news/8525697700573E1885256EAE004C9306 (652 words)

	PRESS RELEASE Study on Dual-Acting Insulin Analog Novolog(R) Mix 70/30 Suggests Alternate Approach to Treating Type 2 ... (Site not responding. Last check: 2007-10-24)
		The participants first underwent a four-week run-in period to optimize their metformin dose, then were randomly assigned to self-administer one of three therapies each day for 12 weeks: NovoLog® Mix 70/30 10 minutes before dinner, biphasic human insulin 30 minutes before dinner, or NPH insulin at bedtime (10:00 p.m.).
		NovoLog® Mix 70/30 contains a rapid-acting form of insulin (30 percent) that controls postprandial glycemia (the rise in blood glucose following food consumption) and allows convenient mealtime dosing; the long-acting insulin component (70 percent) controls blood glucose levels between meals.
		NovoLog® Mix 70/30 FlexPen represents the latest generation of prefilled, disposable insulin pens from Novo Nordisk, designed to be discreet to use.
	www.marketwire.com /mw/release_html_b1?release_id=59713 (1078 words)

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