Comparison of efficacy between postprandial and preprandial injection of glulisine

Objective To compare the therapeutic effect of postprandial and preprandial injection of glulisine. Methods Sixty hospitalized patients with T2DM receiving one dose of glargine and three doses of glulisine were recruited. They were randomly divided into two groups: group A and group B when the glycemic state and insulin dosages had been stable for more than seven days. Two-stage cross design: stage 1: group A (n=30) : glulisine was injected before meal; Group B (n=30) : glulisine was injected after meal. Blood glucose was monitored for three days. Stage 2: glulisine was injected after meal in group A while before meal in group B without dosages adjustment, and blood glucose was monitored continuously for three days. Then standard deviation of blood sugar (SDBG) , blood glucose fluctuation after meal (PPGE) , maximum blood glucose fluctuation range (LAGE) during 24 hour and satisfaction values of insulin treatment (SVIT) were compared. Results There was no significant differences between group A and group B in terms of age ( (50.70±13.29) years vs (55.63±13.05) years, P=0.152) , diabetes course ( (36.23±29.20) months vs (43.63±32.19) months, P=0.355) , HbA1c ( (10.05%±1.46%) vs (9.81%±2.08%, P=0.612) , daily insulin dose ( (35.67±8.64) U vs (34.83±8.24) U, P=0.704) , SDBG ( (2.63±0.58 vs (2.84±0.64) ) before operation. There was no significant differences of SDBG (F=0.432, P=0.73) , PPGE (F=1.216, P=0.31) , LAGE (F=0.431, P=0.73) or SVIT (F=0.685, P=0.56) between glulisine injected before and after meal. Conclusion Postprandial glulisine administration can provide the same effect in lowering glucose, satisfaction values and reducing glucose fluctuation as preprandial injection. Key words: Insulin glulisine; Blood glucose; Type 2 diabetes mellitus; Satisfaction values