Tsujino D, et al. - This randomized controlled trial was performed to compare the efficacy of insulin detemir and biphasic insulin aspart-30 given in the morning as an add-on to oral hypoglycemic agents (OHAs) in type 2 diabetic patients. Compared to the long-acting insulin preparation, the biphasic insulin analogue could represent a better insulin option in significantly lowering %CV and MAGE, as once-daily insulin injection therapy given before breakfast in type 2 diabetes.

• A total of 30 patients with poorly controlled type 2 diabetes (8%≤HbA1c<11%) being treated with OHA mono- or combination therapy with biguanides, sulfonylureas, or thiazolidinediones were enrolled.
• The authors randomly assigned patients to insulin detemir (group D) or insulin aspart-30 (group A) given in the morning as add-on to OHAs.
• After adjusting their insulin doses, the patients underwent continuous glucose monitoring (CGM) during a 3-day hospitalization and Day 2 CGM data were subjected to analysis.

• During CGM, no significant difference was found in patient background, baseline HbA1c levels, and insulin doses between the two groups.
• In group A (20.4 ± 7.6), the %CV of 24-hour glucose levels was significantly lower than in group D (27.1 ± 6.5) (P = 0.015).
• Likewise, in group A (79.9 ± 31.9), MAGE was significantly smaller than in group D (101.8 ± 13.8) (P = 0.021).
• After breakfast, postprandial glucose excursions were significantly smaller in group A (65 ± 31 mg/dL) than in group D (106 ± 32 mg/dL) (P = 0.002).