Xia Y, Hu Y, Ma JH. Premixed insulin: Advantages, disadvantages, and future. World J Diabetes 2025; 16(3): 102526 [PMID: 40093285 DOI: 10.4239/wjd.v16.i3.102526]
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05781239
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January 24, 2025, 12:40
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Reader Comments:
I congratulate the authors for the publication of their write up. It is well written with practical points. The information on greater likelihood of antibody generation with premixed insulins was new to me, although I believe it would have been partly due to the highly prevalent use of this form of insulin.
I would like the authors to understand this point as well while promoting the advantages of the newer insulins. In the international guidelines, at diagnosis of diabetes if the blood glucose levels are above 300 mg/dl and/or glycosylated hemoglobin level is more than 10 %, it is suggested to start the patient on insulin to reduce the glucotoxicity. Once the blood glucose levels reduce, say after 2-3 weeks, the patient may be switched to oral anti-diabetic agents. Such a guideline recommended practice is regularly followed in developing countries such as ours. In such a situation I have observed that the acceptance rate of premixed insulin which involves two pricks, is a lot better than that of multiple short acting insulin doses along with basal insulin. Since the duration of premixed insulin therapy in this context is short, the possible side effects of anti-insulin antibody generation as well as lipodystrophy are less likely.
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