Co-Formulations as the First Injectable in Type 2 Diabetes: A Review of Efficacy, Safety, and Implications in Clinical Practice

John, Mathew; Gopinath, Deepa; Oommen, Tittu

doi:10.1159/000509045

Cited by 2 publications

(1 citation statement)

References 66 publications

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“…IDegAsp is the first soluble co-formulation insulin and comprises two insulin analogues that cover both basal and prandial glycemic control [16,17]. As a co-formulation of both basal and prandial insulin, IDegAsp has become the solution to the quandary of first-time insulin users who had to choose between basal and prandial.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Insulin Degludec/Insulin Aspart (IDegAsp) in Type 2 Diabetes: Systematic Review and Meta-Analysis

Edina¹,

Tandaju²,

Wiyono³

2022

Cureus

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Type 2 diabetes mellitus is a prevalent metabolic disease requiring tight glycemic control of basal and postprandial glucose levels. Treatment intensification using separate basal and bolus injections increased the number of injections and reduced cost-effectivity, leading to decreased compliance and failure of glycemic control. Insulin Degludec/Insulin Aspart (IDegAsp), a novel premix of basal and bolus insulin, is one of the potential treatments for reducing the number of injections. However, its efficacy and safety have not been reviewed clearly. Therefore, this systematic review aims to compare the efficacy and safety of IDegAsp with standard basal and basal plus bolus insulin regimens.A systematic review of four databases (Pubmed, Scopus, Science Direct, and Proquest) was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Search results were screened by eligibility criteria and critically appraised by the Oxford Centre for Evidence-Based Medicine (CEBM) tool and the Cochrane risk-of-bias assessment tool. Meta-Analysis was done using Review Manager to obtain cumulative outcomes from hemoglobin A1C (HbA1C) changes, hypoglycemia incidents, and weight gain from all studies.Out of 132 search results, 10 studies were reviewed. IDegAsp once-daily administration was proven beneficial in reducing HbA1c levels and nocturnal hypoglycemia incidences, while IDegAsp twice-daily administration was proven beneficial in lowering hypoglycemia incidence and nocturnal hypoglycemia incidence. IDegAsp yielded better glycemic index results and lowered hypoglycemic incidents in the metaanalysis.Thus, it is concluded that IDegAsp once daily with stepwise titration on the largest meal of the day achieved most benefits with minimal risks.

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Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Insulin Degludec/Insulin Aspart (IDegAsp) in Type 2 Diabetes: Systematic Review and Meta-Analysis

Edina¹,

Tandaju²,

Wiyono³

2022

Cureus

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Comparing Time to Intensification between insulin Degludec/Insulin Aspart and Insulin Glargine

Kovil

2022

Journal of Diabetology

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Background and Aims: The objective of the study was to compare the percent of patients with type 2 diabetes (T2D) requiring dose intensification and the time to dose intensification in patients on insulin degludec/insulin aspart (IDegAsp) versus those on basal insulin. Materials and Methods: Data were collected through retrospective chart review of patients with T2D being treated with insulin at a single center in India. The increase from once daily (OD) to twice daily dose or the addition of prandial insulin was considered as dose intensification. Chi-square test was conducted to compare the groups. Results: In the IDegAsp group (n = 515), 455 patients continued on the OD dose, and 60 patients (11.6%) were intensified. In the insulin glargine (IGlar) group (n = 173), 143 patients remained on the initial dose and 30 patients (17.34%) were intensified. Fewer patients on IDegAsp required treatment intensification than those on IGlar (P = 0.05). The time to treatment intensification (±standard deviation) was 11.98 ± 7.81 months in the IDegAsp group and 6.71 ± 6.86 months in the IGlar group. The time to treatment intensification was significantly longer in the IDegAsp than in the IGlar group (P = 0.0023). Conclusions: The study shows that significantly fewer patients on IDegAsp required dose intensification than those on IGlar. Additionally, the time to dose intensification was significantly delayed in patients on IDegAsp as compared to IGlar. However, HbA1c reduction with IGlar (nonintensified) was significant only at 6 months and failed to reach significance at 12 months, thereby pointing toward an early need for treatment intensification.

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Co-Formulations as the First Injectable in Type 2 Diabetes: A Review of Efficacy, Safety, and Implications in Clinical Practice

Cited by 2 publications

References 66 publications

Efficacy and Safety of Insulin Degludec/Insulin Aspart (IDegAsp) in Type 2 Diabetes: Systematic Review and Meta-Analysis

Efficacy and Safety of Insulin Degludec/Insulin Aspart (IDegAsp) in Type 2 Diabetes: Systematic Review and Meta-Analysis

Comparing Time to Intensification between insulin Degludec/Insulin Aspart and Insulin Glargine

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