Diabetology International

, Volume 5, Issue 2, pp 117–121

Evaluation of thrice-daily injections of insulin Lispro Mix 50/50 versus basal-bolus therapy in perioperative patients with type 2 diabetes


  • Kyu Yong Cho
    • Hokkaido University School of Medicine
  • Osamu Nakagaki
    • Hokkaido University School of Medicine
    • Hokkaido University School of Medicine
  • Kazumasa Akikawa
    • Obihiro-Kosei General Hospital
  • Tatsuya Astumi
    • Hokkaido University School of Medicine
Original Article

DOI: 10.1007/s13340-013-0140-0

Cite this article as:
Cho, K.Y., Nakagaki, O., Miyoshi, H. et al. Diabetol Int (2014) 5: 117. doi:10.1007/s13340-013-0140-0



The purpose of this study was to compare two perioperative insulin therapies [thrice-daily injections of insulin Lispro Mix 50/50 (3X-Mix50) versus basal-bolus injections (BBT)] in type 2 diabetic patients who were judged by attending endocrinologists to require intensive insulin treatment before surgery.

Materials and methods

A retrospective analysis was performed on data collected from 47 surgical patients hospitalized at Obihiro-Kosei General Hospital and treated with BBT (n = 27) or 3X-Mix50 (n = 20) for 1 year.


Patient baseline characteristics (age, duration of diabetes, BMI, FPG and HbA1c) were similar between therapeutic groups. Both therapies achieved target glycemic control for surgery in 9 days on average. There was no significant difference in average pre-meal or bedtime blood glucose levels. The total daily insulin dose before surgery was similar (28.3 U in BBT vs. 24.8 U in 3X-Mix50, p = 0.1146). No episodes of severe hypoglycemia occurred, and the number of episodes of mild hypoglycemia during the perioperative period was similar. No surgical complications such as infection occurred, and one orthopedic surgery-related issue occurred in each therapeutic group.


We showed 3X-Mix50 and BBT were comparable in terms of glycemic control, total insulin dose, and incidence of hypoglycemia and perioperative complications. While comparable to classical BBT therapy, the 3X-Mix50 provides a convenient alternative method for maintaining glycemic control in patients with type 2 diabetes during the perioperative period.


Type 2 diabetes Insulin Lispro Mix 50/50 Basal-bolus therapy Perioperative period Surgical complications

Copyright information

© The Japan Diabetes Society 2013