***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE The goal of this study was to compare the efficacy and safety profiles of biphasic insulin aspart 30 ( 30 % soluble insulin aspart and 70 % protaminated insulin aspart [ BIAsp 30 ] ) and biphasic insulin lispro 25 ( 25 % soluble insulin lispro and 75 % neutral protamine lispro [ Mix25 ] ) used in a BID injection regimen in patients with type 2 diabetes mellitus ( DM ) . Also assessed was patients ' preference for pen device -- the NovoMix 30 FlexPen /NovoLog Mix 70/30 FlexPen ( FlexPen ) versus the Humalog Mix25 Pen/Humalog Mix75/25 Pen ( Humalog Pen ) . METHODS Patients with type 2 DM receiving current insulin treatment were r and omized to a multinational , multicenter , open-label , 2-period , crossover comparison of BIAsp 30 and Mix25 .  Efficacy ( by analyses of variance ) and safety profiles were assessed after 12 weeks of treatment . Patients ' preference for pen device was assessed by question naires . RESULTS A total of 137 patients were r and omized to treatment ; 4 were withdrawn during the 2-week run-in treatment with biphasic human insulin 30 . The mean ( SD ) characteristics of the remaining 133 patients ( 79 men , 54 women ) were as follows : age , 62.3 ( 9.2 ) years ; body mass index , 28.1 ( 3.9 ) kg/m(2 ) ; and glycosylated hemoglobin ( HbA(1c ) ) , 8.5 % ( 1.1 ) . Glycemic control was assessed by the measurement of HbA(1c ) after 12 weeks of treatment . Treatment with BIAsp 30 was noninferior to treatment with Mix25 ( upper limit of 90 % CI for estimated difference [ BIAsp 30 - Mix25 ] was < 0.4 % ) . Self-monitored blood glucose levels were comparable ( P = NS ) . Adverse-event profiles were similar between treatments , as was the incidence of hypoglycemic episodes ( 0.69 episode/mo with BIAsp 30 and 0.62 episode/mo with Mix25 , P = 0.292 ) . For all device features assessed , the FlexPen consistently received higher scores ( all P < 0.005 ) . A total of 9.0 % of patients experienced problems with the FlexPen , compared with 32.4 % with the Humalog Pen ( P < 0.001 ) . Furthermore , 74.6 % preferred to continue using the FlexPen , whereas 14.3 % preferred the Humalog Pen ( P < 0.001 ) . CONCLUSIONS In this study , glycemic control with BIAsp 30 and Mix25 was found to be comparable in these patients with type 2 DM .  Safety profiles were similar for both regimens . Patients preferred and experienced fewer problems with the FlexPen than the Humalog Pen Abbreviations ACCORD Action to Control Cardiovascular Risk in Diabetes ADVANCE Action in Diabetes and Vascular Disease : Preterax and Diamicron Modified-Release Controlled Evaluation AGI α-Glucosidase inhibitor  CAD Coronary artery disease CKD Chronic kidney disease CVD Cardiovascular disease DPP-4 Dipeptidyl peptidase IV GIP Glucose-dependent insulinotropic peptide GLP-1 Glucagon-like peptide 1 NPH Neutral protamine Hagedorn TZD Thiazolidinedione UKPDS UK Prospect i ve Diabetes Study VADT Veterans Affairs Diabetes Medication compliance may be a problem in the management of patients with diabetes . Some physicians initially treat patients having non-insulin-dependent diabetes with oral sulfonylureas because they fear greater compliance problems with insulin therapy . We compared compliance with insulin and chlorpropamide in patients newly beginning medication for NIDDM . Seventy-seven adults with hyperglycemia despite diet therapy were r and omly assigned to chlorpropamide or insulin . Compliance was measured four times over 24 wk . Patients then crossed over to the other medication and were followed for 24 additional weeks . Overall , there were no differences in compliance with the two medications in terms of percent of prescription used , proportion taking at least 80 % of prescribed medication , self-report of medication or diet compliance , or protocol dropout rates . However , treatment satisfaction was higher with chlorpropamide , and most patients preferred chlorpropamide to insulin ( P < 0.0001 ) . While such differences in satisfaction may affect long-term compliance , physicians should not assume that their patients will be less compliant with insulin than with oral sulfonylureas ABSTRACT Background : Diabetes mellitus ( DM ) affects over 18.2 million Americans and diabetes-related medical costs exceed 132 billion dollars per year , totaling more than 12 % of the United States healthcare budget . The Diabetes Control and Complications Clinical Trial demonstrated that intensive insulin therapy and the control of plasma glucose can significantly reduce the incidence of late diabetic complications and delay the progression of existing conditions in type 1 diabetes . Optimal glycemic control often requires intensive insulin therapy to maintain a hemoglobin A1C ( A1C ) of less than 7 % as recommended by the American Diabetes Association . It is estimated that more than half of the approximately 7 million Americans using insulin do so with suboptimal treatment and while administering one or two insulin injections per day . Non-adherence may be a contributing factor in suboptimal treatment . For a variety of reasons , many patients diagnosed with diabetes and treated with insulin are non-adherent . Scope : The primary objective of this study was to evaluate preference for an insulin delivery system comparing a disposable doser ( InnoLet ) to the st and ard vial/syringe . In a prospect i ve , r and omized , open-label , two-period , crossover study , 260 patients were enrolled ( age ≥ 18 years , with type 1 or 2 diabetes , and receiving NPH or regular or 70/30 insulin for at least 6-months ) . A total of 162 patients completed both treatment arms . Excluded were those unable to read/write English or administer their own injections , pregnant/lactating women , those using antipsychotics , and those with a history of alcohol abuse or cognitive impairment . Patients completed the eight-item Diabetes Fear of Self-Injection Question naire at baseline , week 12 and week 24 . Items were rated on a 4-point Likert scale ( 1 = almost never ; 4 = almost always ) with a maximum fear score of 32 . At week 24 , patients completed a preference survey . Findings : Of the 162 patients completing both treatment arms , 89 ( 55.0 % ) were in the vial/syringe to disposable doser treatment arm , 50 % were female and mean age was 60 ± 11 years . Patients in both treatment arms displayed little significant differences in baseline characteristics . Patients reported significantly lower fear of self-injection after using the disposable doser compared to vial/syringe ( mean ± SEM : 9.5 ± 0.2 vs. 11.2 ± 0.4 ; p < 0.0001 ) . Most patients ( 71.5 % ) indicated a preference for the disposable doser compared to the vial/syringe method ( p < 0.0001 ) . Conclusion : The majority of patients preferred the disposable doser , and reported significantly less fear of self-injection using this delivery system . There are some potential limitations to consider . A r and omization bias may have been present , patients who enrolled in this study were those who were actively seeking medical treatment for diabetes , insulin pens and cartridges are not available for all types of insulin regimens , pre-filled pens and cartridges may not be altered and , in general , alternative insulin delivery systems tend to be more costly than insulin sold in traditional vials . However , insulin may have greater patient acceptance and less psychological distress when administered via an alternative delivery system Insulin lispro is an insulin analogue that has the advantages of being fast-acting , convenient , and less likely to lead to hypoglycaemic episodes . Previous studies have proven its value in treating both Type 1 and Type 2 diabetes  both alone and in combination with different treatment regimens.1,2 However , diabetes is heterogeneous and differs in etiology and clinical characteristics in different ethnic groups . Even with the same insulin treatment , different diets will produce different glycaemic profiles . Diet patterns differ between different ethnic groups . Traditional oriental foods are characterized by a higher proportion of carbohydrates and a lower proportion of fat compared to Caucasian diets . To date , there has been no study on the use of insulin lispro in Chinese diabetic patients . Whether the Chinese dietary pattern will affect the efficacy of  insulin lispro treatment remains unknown . Therefore , we conducted this trial to assess the efficacy of insulin lispro treatment in Chinese patients OBJECTIVE This study assessed acceptability of a new 3.0-mL prefilled insulin pen device , the Humulin/Humalog Pen , as a method of delivering human insulin . Secondary objectives were to determine whether the pen device might facilitate initiation of insulin therapy in patients currently receiving oral antihyperglycemic agents and to monitor the safety of this pen device in clinical practice . BACKGROUND For both the patient and health care provider , significant negative perceptions of the use of insulin therapy persist , including patient inconvenience , social stigma from insulin injections , and insufficient time for the provider to train the patient . METHODS This 6-week , open-label , noncomparative study was conducted at 33 centers in the United States . Patients with type 1 or type 2 diabetes treated with insulin therapy or oral antihyperglycemic agents were enrolled in the study . Before the study , 62 % ( 194 patients ) had used a syringe and vial for insulin injection , 28 % ( 87 patients ) had used an insulin pen device , and 10 % ( 30 patients ) were insulin-naive . Prior therapy was unknown in 1 % ( 4 patients ) . Patients used the Humulin/Humalog Pen for > or = 1 injection of insulin daily for 6 weeks . At the beginning and end of the study , patients completed a question naire design ed to elicit their perceptions of the Humulin/Humalog Pen ; physicians completed a question naire at the end of the study . Frequencies and percentages of all categoric responses were calculated and summarized . RESULTS A total of 315 patients ( 136 type 1 , 179 type 2 diabetes ) were enrolled . Of the 299 patients who completed question naires at the end of the study , 76 % ( 226 patients ) were somewhat or extremely satisfied with the pen , 78 % ( 234 patients ) probably or definitely would continue to use the pen , and 80 % ( 239 patients ) probably or definitely would recommend the pen to others . Of the 33 physicians who completed question naires at the end of the study , 97 % ( 32 ) thought that the pen was better overall compared with a vial and syringe , 88 % ( 29 ) thought that it took less time to teach patients to use the pen , and 73 % ( 24 ) thought that it took less time to initiate insulin therapy with the pen . CONCLUSIONS The Humulin/Humalog Pen had an acceptable safety profile and was well accepted by patients and physicians A new re-usable insulin pen ( the HumaPen ) was tested in a multinational study in patients with Type 1 ( 45.1 % ) or Type 2 ( 54.9 % ) diabetes . Prior to study entry , patients used either syringes or a comparison pen . Patients changed to the HumaPen for all insulin injections during the 5-to 7-week study and a 12- to 13-week extension period . Acceptability of the HumaPen was assessed from a question naire completed at the end of the study by 72 previous syringe users and 209 previous pen users .  HumaPen features considered easy/very easy by pre- study syringe users or pre- study pen users were correcting a mis-dialled dose ( 97.2 % ; 95.1 % , respectively ) , reading the dose numbers ( 95.8 % ; 97.1 % ) and ease of learning ( 95.8 % ; 92.3 % ) . Convenience , comfort and ease of use were stated to be better by a majority of pre- study syringe users and similar by pre- study pen users . At the end of the initial study , 73.6 % of syringe users and 55.5 % of previous pen users said they would continue to use the HumaPen , and 171 patients continued into the extension . As expected , the most common adverse event was hyperglycaemia but the majority were mild and none caused discontinuation from HumaPen use . The main reason for not continuing into the extension period , and for return of pens , was the injection force , which was subsequently reduced by modification of design and production prior to launch . The HumaPen therefore appeared well accepted and safe in this global study and a majority said they would recommend it to other patients BACKGROUND The accuracy and convenience of pen devices for insulin injection have improved quality of life for patients with insulin-treated diabetes mellitus ( DM ) . Prefilled , disposable pens have the advantage of simplicity , with minimal training and attention required and no 
    Output:
    
Conclusions and implication s of key findings This study provides the first systematic evaluation of the methods used in the broad existing body of research into  patient preferences for type 2 diabetes medications and can serve as a primary source of information for decision makers .