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The industry-sponsored “4-T” study was designed to examine various insulin regimens in patients with type 2 diabetes. Researchers randomized 708 patients with type 2 diabetes who were taking metformin and a sulfonylurea (glycosylated hemoglobin [HbA1c] level, 7%–10%) to receive one of three insulin regimens, added to their oral drugs:
Once-daily basal insulin detemir (Levemir)
Twice-daily biphasic insulin aspart (NovoMix 30)
Thrice-daily prandial insulin aspart (NovoRapid)
During the trial, if HbA1c levels remained higher than 6.5% despite insulin titration, sulfonylurea was stopped and a second insulin was added (3 prandial injections added in the basal group; 1 lunchtime prandial injection added in the biphasic group; or 1 basal insulin injec…