Saudi Consensus for Low-Premixed Insulin Analogues in Type 2 Diabetes: Consensus Report

Dear Dr. Martin Hovland, We learned from the literature that premixed insulins are short-acting insulin or rapid-acting insulin analogue mixed with intermediate-acting insulin in a fixed ratio, addressing FBG and PPBG in one injection. There are two categories; high-mix and low-mix premixed insulins. We, a Saudi task force, gathered to develop an explicit, evidence-based consensus for the use of the low-mix premixed insulin for better glycemic control. The treatment with premixed aspart 30 was non-inferior to treatment with premixed insulin lispro 25. In addition, Self-monitored blood glucose levels were comparable. Safety profiles were similar between both treatments, as was the incidence of hypoglycemic episodes. The switch between both products of the low-mix family can be carried out without any problem. Both products of the low-mix premixed insulin analogues aspart 30/70 and premixed insulin lispro 25/75 have comparable efficacy and safety as shown from the medical literature. Therefore, we can change from one to another safely as demonstrated by the US FDA statement. In addition, the ergonomic features of KwikPen’s design and function may offer important advantages for the user during insulin administration.