***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 RESULTS A total of 137 patients were r and omized to treatment ; 4 were withdrawn during the 2-week run-in treatment with biphasic human insulin 30 .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 OBJECTIVE Insulin detemir is a soluble long-acting basal insulin analog design ed to overcome the limitations of conventional basal insulin formulations . Accordingly , insulin detemir has been compared with NPH insulin with respect to glycemic control ( HbA1c , prebreakfast glucose levels and variability , and hypoglycemia ) and timing of administration . RESEARCH DESIGN AND METHODS People with type 1 diabetes ( n = 408 ) were r and omized in an open-label , parallel-group trial of 16-week treatment duration using either insulin detemir or NPH insulin . Insulin detemir was administered twice daily using two different regimens , either before breakfast and at bedtime ( IDet(morn+bed ) ) or at a 12-h interval ( IDet(12h ) ) . NPH insulin was administered before breakfast and at bedtime . Mealtime insulin was given as the rapid-acting insulin analog insulin aspart . RESULTS With both insulin detemir groups , clinic fasting plasma glucose was lower than with NPH insulin ( IDet(12h ) vs. NPH , -1.5 mmol/l [ 95 % CI -2.51 to -0.48 ] , P = 0.004 ; IDet(morn+bed ) vs. NPH , -2.3 mmol/l ( -3.32 to -1.29 ) , P < 0.001 ) , as was self-measured prebreakfast plasma glucose ( P = 0.006 and P = 0.004 , respectively ) . The risk of minor hypoglycemia was lower in both insulin detemir groups ( 25 % , P = 0.046 ; 32 % , P = 0.002 ; respectively ) compared with NPH insulin in the last 12 weeks of treatment , this being mainly attributable to a 53 % reduction in nocturnal hypoglycemia in the IDet(morn+bed ) group ( P < 0.001 ) . Although HbA1c for each insulin detemir group was not different from the NPH group , HbA1c for the pooled insulin detemir groups was significantly lower than for the NPH group ( mean difference -0.18 % [ -0.34 to -0.02 ] , P = 0.027 ) . Within-person between-day variation in self-measured prebreakfast plasma glucose was lower for both detemir groups ( both P < 0.001 ) . The  NPH  group gained weight during the study , but there was no change in weight in either of the insulin detemir groups ( IDet(12h ) vs. NPH , -0.8 kg [ -1.44 to -0.24 ] , P = 0.006 ; IDet(morn+bed ) vs. NPH , -0.6 kg [ -1.23 to -0.03 ] , P = 0.040 ) . CONCLUSIONS Overall glycemic control with insulin detemir was improved compared with NPH insulin . The data provide a basis for tailoring the timing of administration of insulin detemir to the individual person 's needs BACKGROUND AND AIM While lispro insulin has been reported to lower postpr and ial blood glucose concentrations , less consistent effects have been shown for glycosylated hemoglobin ( HbA1c ) levels . Aim of this study was to determine whether pre-meal association of NPH , an intermediate-acting insulin , with lispro improves overall glycemic control in type 1 diabetic patients . METHODS AND RESULTS Eighty-five type 1 diabetic patients were studied in a multicenter r and omized comparative ( human regular vs lispro insulin ) crossover ( 3-month ) study in which NPH insulin was given as a dinner or bedtime injection and at breakfast and lunch if necessary . The number of injections was kept constant : 42 % and 58 % of patients injected insulin 3 and 4 times per day , respectively . Fasting and prepr and ial blood glucose levels were similar , while postpr and ial levels improved after lispro compared to human regular insulin ( breakfast : 8.28 + /- 2.39 vs 9.28 + /- 2.72 mmol/l ; lunch : 8.33 + /- 2.67 vs 9.06 + /- 2.67 mmol/l , dinner : 8.06 + /- 2.72 vs 9.28 + /- 2.44 mmol/l , ANOVA : p = 0.003 ) . HbA1c also improved after lispro : 8.1 + /- 0.9 vs 8.3 + /- 0.8 % , p < 0.05 . The rate of hypoglycemia was similar . Patients showed better acceptance of lispro treatment ( p < 0.001 ) . CONCLUSIONS Lispro improves overall blood glucose control in type 1 diabetic patients without increasing the incidence of hypoglycemia . This can be achieved by an optimal combination of lispro insulin with NPH whenever the time intervals between meals are too long OBJECTIVE This study investigated the effect of insulin glargine ( LANTUS ) versus NPH insulin on metabolic control and safety in Asian patients with Type 2 diabetes , inadequately controlled on oral hypoglycemic agents ( OHAs ) . STUDY DESIGN AND METHODS In this open-label , r and omized , parallel , multinational , 24-week , non-inferiority study , 443 patients received either once-daily insulin glargine ( n=220 ) or NPH insulin ( n=223 ) at bedtime , plus glimepiride ( Amaryl ) . RESULTS Baseline characteristics were similar between the two groups . HbA(1c ) levels decreased in the insulin glargine and NPH groups over the study period in the per- protocol ( PP ; -1.10 % versus 0.92 % ) and full- analysis ( FA ; -0.99 % versus -0.77 % ) population s. In the PP population , the difference between adjusted means ( predefined equivalence region > -0.4 % ) was 0.19 % ( 90 % confidence interval [ CI ] : 0.02 , 0.36 ) , demonstrating non-inferiority between the two treatments . In a superiority analysis ( FA population ) , the difference between adjusted mean changes in the two groups was 0.22 % ( 95 % CI : 0.02 , 0.42 ) , demonstrating the superiority of insulin glargine ( p=0.0319 ) . Moreover , the number of hypoglycemic episodes was significantly lower with insulin glargine versus NPH insulin ( p<0.004 ) , particularly severe ( p<0.03 ) and nocturnal ( p<0.001 ) . Daily insulin dose increased from 9.6+/-1.5 to 32.1+/-17.6 U in the insulin glargine group and from 9.8+/-1.9 to 32.8+/-18.9 U in the NPH insulin group . CONCLUSION These results confirm earlier reports that insulin glargine provides superior glycemic control with less hypoglycemia and demonstrates that these benefits are consistent between different ethnicities Aims /hypothesisThe aim of the trial was to compare the efficacy and tolerability of two types of basal-bolus therapy , using either the soluble long-acting basal insulin analogue , insulin detemir , in combination with the rapid-acting analogue , insulin aspart , or NPH insulin in combination with mealtime regular human insulin . Methods In this 18-week , 1:1 r and omised , open-labelled , parallel trial , 595 patients with Type 1 diabetes mellitus received insulin detemir or NPH insulin in the morning and at bedtime in combination with mealtime insulin aspart or regular human insulin respectively . Results Glycaemic control with insulin detemir/insulin aspart was improved in comparison with NPH insulin/regular human insulin ( HbA1c : 7.88 % vs 8.11 % ; mean difference : −0.22 % point [ 95 % CI : −0.34 to −0.10 ] ; p<0.001 ) . Self-measured 8-point plasma glucose profiles differed between the groups ( p<0.001 ) , with lower postpr and ial plasma glucose levels in the insulin detemir/insulin aspart group . Within-person day-to-day variation in plasma glucose was lower with insulin detemir/insulin aspart than with NPH insulin/regular human insulin ( SD : 2.88 vs 3.12 mmol/l ; p<0.001 ) . Risk of overall and nocturnal hypoglycaemia ( 23.00–06.00 hours ) was , respectively , 21 % ( p=0.036 ) and 55 % ( p<0.001 ) lower in the insulin detemir/insulin aspart group than in the NPH insulin/regular human insulin  group . Body weight ( adjusted for baseline and change in HbA1c ) was 1 kg lower with insulin detemir/insulin aspart than with NPH insulin/regular human insulin ( p<0.001 ) . Conclusions /interpretationBasal-bolus therapy using insulin detemir/insulin aspart offers a better balance of control and tolerability than with NPH insulin/regular human insulin . The low variability and more physiological action profiles generated with these insulin analogues result ed in improved glycaemic control with lower risk of hypoglycaemia and no concomitant body weight increase OBJECTIVE —To assess the safety and efficacy of insulin aspart ( IAsp ) versus regular human insulin ( HI ) in basal-bolus therapy with NPH insulin in pregnant women with type 1 diabetes . RESEARCH DESIGN AND METHODS —Subjects ( n = 322 ) who were pregnant or planning pregnancy were r and omized to IAsp or HI as meal-time insulin in an open-label , parallel-group , multicenter study . Subjects had A1C ≤8 % at confirmation of pregnancy . Insulin doses were titr 
    Output:
    
There were insufficient data to determine whether insulin analogues are better than conventional insulins in reducing long-term diabetes-related complications or death .
INTERPRETATION Rapid- and long-acting insulin analogues offer little benefit relative to conventional insulins in terms of glycemic control or reduced hypoglycemia .