Comparative Efficacy of Basal-Bolus Versus Premixed Insulin Regimens in Achieving Glycemic Control Among Patients with Type 2 Diabetes Mellitus: A Systemic Review

Authors

  • Dawood Khan Department of Internal Medicine, Lady Reading Hospital , Peshawar, Pakistan.
  • Lintha Zafar Department of Internal Medicine Khyber Teaching Hospital, Peshawar, Pakistan.
  • Sadaf Faryal Department of Internal Medicine Lady Reading Hospital, Peshawar, Pakistan.
  • DurreBeda Department of Internal Medicine Khyber Teaching Hospital, Peshawar, Pakistan.
  • Zainab Shakeel Department of Internal Medicine Shaukat Khanam Memorial Cancer Hospital, Peshawar, Pakistan .
  • Muhammad Waqas Private Skin Clinic, Peshawar, Pakistan.
  • Naqeeb Ullah Department of Internal Medicine Lady Reading Hospital , Peshawar, Pakistan.
  • Mahwash Nazir Department of General Medicine Borders General Hospital, Melrose on the A6091, Scotland .
  • Sumaira Nazir Department of Public health Cardiff University Cardiff Heath Hospital, United Kingdom.

DOI:

https://doi.org/10.70749/ijbr.v2i02.177

Keywords:

T2DM, BSI, PZI, Glycometabolic Management, Insulin Regimes, Self-Monitored Blood Glucose Levels, Insulin Therapy, Hypoglycemia

Abstract

Background: T2DM is one of the most prevalent chronic illnesses, requiring effective management to prevent complications. Oral antidiabetic agents are typically needed only in the initial stage to control blood glucose level, while insulin therapy becomes essential as the disease progresses. This includes both basal-bolus and premixed insulin regiments. Therefore, defining an optimal treatment schedule is crucial to improve outcomes in T2DM management and minimize associated attack.

Objective: This systematic review assesses the efficacy and safety of the basal-bolus regimen compared to premixed insulin in treating glycemia in T2DM.

Methods: The study search involved PubMed, EMBASE, Cochrane Library, and Scopus; the search done strictly applied the PRISMA guidelines. A Review of RCTs, cohort studies, and systematic reviews for comparing basal-bolus regimens to the premixed insulin regimens in A-T2DM was done. These were HbA1c, FPG, and PPG. Secondary endpoints were the incidence of hypoglycemia, adherence to therapy, and disease-specific quality of life.

Results: From the above search, we identified 45 studies that meet the inclusion criteria. Daily basal-bolus regimens demonstrated a slightly better reduction in HbA1c, FPG, and PPG than premixed regimens with the trade-offs related to hypoglycemia and regimen complexity. However, basal-bolus regimens are disadvantaged by having more hypoglycemia episodes than the a priori premixed regimens for patients requiring fewer injections.

Conclusion: While basal-bolus regimens give better glycaemic control than premixed ones, the latter are safer and easier to use in some patients. Sources call into question of patient’s characteristics in particular, features of T2DM, the patient’s behavior, and his/her genetic background in order to come up with the most effective and individualized treatment plan more consequently than in any other case.

Author Biographies

Dawood Khan, Department of Internal Medicine, Lady Reading Hospital , Peshawar, Pakistan.

House Officer

Lintha Zafar, Department of Internal Medicine Khyber Teaching Hospital, Peshawar, Pakistan.

House Officer

Sadaf Faryal , Department of Internal Medicine Lady Reading Hospital, Peshawar, Pakistan.

House Officer

DurreBeda, Department of Internal Medicine Khyber Teaching Hospital, Peshawar, Pakistan.

House Officer

Zainab Shakeel, Department of Internal Medicine Shaukat Khanam Memorial Cancer Hospital, Peshawar, Pakistan .

Medical Officer

Muhammad Waqas , Private Skin Clinic, Peshawar, Pakistan.

Medical Officer

Naqeeb Ullah , Department of Internal Medicine Lady Reading Hospital , Peshawar, Pakistan.

Resident Physician

Mahwash Nazir, Department of General Medicine Borders General Hospital, Melrose on the A6091, Scotland .

FY2

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Published

2024-11-11

How to Cite

Khan, D., Zafar, L., Faryal , S., DurreBeda, Shakeel, Z., Muhammad Waqas, Naqeeb Ullah, Nazir, M., & Nazir, S. (2024). Comparative Efficacy of Basal-Bolus Versus Premixed Insulin Regimens in Achieving Glycemic Control Among Patients with Type 2 Diabetes Mellitus: A Systemic Review. Indus Journal of Bioscience Research, 2(02), 286–293. https://doi.org/10.70749/ijbr.v2i02.177

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