Switching Patients with Type 1 Diabetes to Insulin Degludec from Other Basal Insulins: Real-World Data of Effectiveness and Safety

Overview

Journal Diabetes Ther

Specialty Cardiology & Vascular Diseases

Date 2019 Nov 11

PMID 31707573

Citations 4

Authors

Paola Ponzani

Cesare Berra

Alessandra Di Lelio

Paola Del Sindaco

Chiara Di Loreto

Francesco Reggiani

Giuseppe Lucisano

Maria Chiara Rossi

Affiliations

Soon will be listed here.

Abstract

Introduction: Real-world evidence on the effectiveness and safety of insulin degludec (IDeg) in patients with diabetes is a priority. We have therefore evaluated the effectiveness and safety of IDeg, including impact on metabolic control, glycemic variability, weight gain and hypoglycemia, in patients with type 1 diabetes under routine clinical practice conditions.

Methods: This was an observational longitudinal multicenter study. A retrospective chart review of all patients with type 1 diabetes who were switched from basal insulin to IDeg was performed, and temporal trends in clinical outcomes were assessed.

Results: Data obtained from 195 patients, with a median age of 42.8 [interquartile range (IQR) 24.6-56.4] years and a median diabetes duration of 16 (IQR 10.0-28) years, were analyzed. Median follow-up was 9.5 (IQR 7.7-11.3) months. Improvements were found in glycated hemoglobin (- 0.34%; p < 0.0001), fasting blood glucose (- 24.82 mg/dL; p < 0.0001), post-prandial glucose (- 17.23 mg/dL; p = 0.0009), glycemic variability as indicated by standard deviation of blood glucose (- 5.67 mg/dL; p < 0.0001) and high blood glucose index (- 3.77; p < 0.0001). Body weight and body mass index remained substantially stable during the follow-up (- 0.18 kg; p = 0.56 and - 0.12; p = 0.42, respectively). Risk of nocturnal hypoglycemia decreased by 52% [incidence rate ratio 0.48; 95% confidence interval (CI) 0.29-0.77] and risk of total hypoglycemic episodes by 41% (incidence ratio 0.59; 95% CI 0.45-0.83). Basal and short-acting insulin doses decreased by - 1.4 and - 3.1 IU, respectively.

Conclusion: Switching patients with type 1 diabetes to IDeg from other basal insulins was associated with relevant improvements in metabolic control and glycemic variability without weight gain; the risk of hypoglycemic episodes also significantly declined.

Funding: Novo Nordisk S.p.A. unconditional grant.

Citing Articles

Diurnal Variation of Real-Life Insulin Sensitivity Factor Among Children and Adolescents With Type 1 Diabetes Using Ultra-Long-Acting Basal Insulin Analogs.

Hegab A Front Pediatr. 2022; 10:854972.

PMID: 35350271 PMC: 8957904. DOI: 10.3389/fped.2022.854972.

Insulin doses requirements in patients with type 1 diabetes using glargine U300 or degludec in routine clinical practice.

San Laureano F, Tome Fernandez-Ladreda M, Jimenez Millan A, Garcia Calzado C, Ayala Ortega M J Investig Med. 2021; 69(5):983-988.

PMID: 33771843 PMC: 8223633. DOI: 10.1136/jim-2020-001633.

Improved Nocturnal Glycaemia and Reduced Insulin Use Following Clinical Exercise Trial Participation in Individuals With Type 1 Diabetes.

McCarthy O, Deere R, Eckstein M, Pitt J, Wellman B, Bain S Front Public Health. 2021; 8:568832.

PMID: 33495732 PMC: 7822762. DOI: 10.3389/fpubh.2020.568832.

Comparative Effectiveness of Switching From First-Generation Basal Insulin to Glargine 300 U/ml or Degludec 100 U/ml in Type 1 Diabetes: The RESTORE-1 Study.

Laviola L, Porcellati F, Bruttomesso D, Larosa M, Rossi M, Nicolucci A Diabetes Ther. 2020; 12(2):509-525.

PMID: 33351177 PMC: 7846660. DOI: 10.1007/s13300-020-00982-z.

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