Comparative safety and efficacy of insulin degludec with insulin glargine in type 2 and type 1 diabetes: a meta-analysis of randomized controlled trials

Abstract

Insulin degludec appears to have better safety in reducing hypoglycemic events with similar efficacy compared with insulin glargine.

Improved Cardiovascular and Cardiometabolic Risk in Patients With Type 1 Diabetes and Autoimmune Polyglandular Syndrome Switched From Glargine to Degludec Due to Hypoglycaemic Variability

“…The decrease of BMI and WC is an interesting finding. A systematic meta-analysis of randomized controlled trials comparing degludec and glargine, both in patients with T1D and T2D, did not show any change in BMI and WC ( 16 ). However, it is well-known that glargine 100 U/ml treatment is associated with weight gain ( 28 , 29 ), compared to other basal insulin such as detemir and glargine 300 U/ml ( 30 , 31 ).…”

“…Degludec insulin has been reported to improve glucose control through a decrease in glycaemic variability and hypoglycaemic episodes and a decrease of insulin doses, notably in the maintenance period ( 14 , 16 , 32 ). In addition, a decrease in insulin requirement and an improvement of HbA1c has also been observed in patients switched from glargine to degludec, even though these results are still quite discordant ( 33 , 34 ).…”

“…The efficacy of insulin degludec for treatment of T1D and its non-inferiority to glargine has been demonstrated in several clinical trials ( 11 – 13 ). Degludec treatment has been associated with a decrease in HbA1c ( 14 ), in daily insulin dose and nocturnal hypoglycaemia, notably in the maintenance period ( 15 , 16 ), with an adverse profile similar to glargine ( 17 ), also in terms of cardiovascular events ( 18 ).…”

Impaired hypoglycemia awareness in diabetes: epidemiology, mechanisms and therapeutic approaches

“…Для пациентов с неадекватно жестким контролем гликемии следует рекомендовать уменьшение доз инсулина. При выборе препаратов инсулина преимущества имеют аналоги, обеспечивающие наименьший риск гипогликемии, согласно результатам РКИ [61,62]: деглудек, гларгин 300 ЕД/мл. Как уже отмечалось, некоторые больные с НРГ имеют неправильные целевые установки в области лечения заболевания и не склонны модифицировать свое поведение.…”

What is innovation in the area of medicines? The example of insulin and diabetes

“…It should be noted that glargine U100 had previously been shown to offer significant advantages over NPH insulin (reduced risk of hypoglycaemia and longer action), and had become the new standard in basal insulin therapy [2]. This advantage of degludec was shown repeatedly, not only in randomized parallel-group trials [3,4], but also in crossover trials [5,6], in a very large-scale cardiovascular outcomes trial [7], and in observational real-world evidence studies [8]. The absolute risk reduction for hypoglycaemia varied according to the cohorts studied, the definitions used, and methodology, but, in a crossover study of basal insulintreated Type 2 diabetes in which overall symptomatic hypoglycaemia was the primary endpoint, the rate ratio during maintenance therapy was significantly lower with degludec than with glargine U100 [0.70 (95% CI 0.61;0.80); P<0.001] [5].…”