Abstract

I recently read with interest the Rizvi article in the November issue of the Southern Medical Journal.¹ The author neatly outlined some important issues regarding epidemiology and pathophysiology of type 2 diabetes. A discussion about the treatment of this disease was also presented. Although the merits of combining insulin to oral therapy and basal-bolus therapy were discussed, I feel that the author omitted an important insulin regimen that is widely used in the treatment of patients with type 2 diabetes. Premixed insulins, particularly analog mixes, are among the most common startup therapies² used worldwide by both specialists and primary care physicians. Premixes, such as biphasic insulin aspart 30, comprise a soluble, rapid-acting portion of insulin, which acts to cover meal-time glucose excursions, and a longer-acting insulin, usually in the form of protaminated analog in these formulations, which means it is released slowly and can therefore cover basal insulin needs. Thus, postprandial glucose and fasting blood glucose, both of which contribute to overall glycemic control, are addressed and controlled in one injection.