Impact of kidney function on the safety and efficacy of insulin degludec versus insulin glargine <scp>U300</scp> in people with type 2 diabetes: A post hoc analysis of the <scp>CONCLUDE</scp> trial

Pieber, Thomas R.; Bajaj, Harpreet S.; Heller, Simon; Jia, Ting; Khunti, Kamlesh; Klonoff, David C.; Ladelund, Steen; Leiter, Lawrence A.; Wagner, Lily; Philis‐Tsimikas, Athena

doi:10.1111/dom.14564

Cited by 5 publications

(2 citation statements)

References 21 publications

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“…Ved forekomst af hypoglykaemi bør man overveje dosisreduktion eller skift til andet insulinregime. Risikoen for isaer natlig hypoglykaemi kan nedsaettes ved brug af de nye generationer af basalinsulinanaloger (insulin degludec og insulin glargin U100 & U300), som har vist sig sikre i behandlingen af diabetes hos personer med CKD uanset graden [19,[25][26][27]. Ligeledes er det påvist, at hurtigtvirkende (prandial/måltids-) insulinanaloger sammenlignet med humant insulin reducerer forekomsten af hypoglykaemi og giver bedre postprandial glykaemisk kontrol [17].…”

Section: Insulinunclassified

Hyperglycaemia in people with diabetes and chronic kidney disease

Brøsen,

Bomholt,

Borg

et al. 2024

Ugeskr Læger

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Assessment and treatment of hyperglycaemia in people with diabetes and chronic kidney disease (CKD) are challenging. In advanced CKD HbA1c can be unreliable, and treatment adjustments should be supported by other glucose measurements (e.g., continuous glucose monitoring (CGM) or blood glucose measurements). Glucose-lowering treatments should be evaluated based on CKD and an individualised assessment of risk factors especially hypoglycaemia. This review aims at providing an overview of the options for glycaemic monitoring and glucose-lowering treatments in people with diabetes and CKD.

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Section: Insulinunclassified

Hyperglycaemia in people with diabetes and chronic kidney disease

Brøsen,

Bomholt,

Borg

et al. 2024

Ugeskr Læger

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“…Long-acting insulin analogs, including U300, insulin degludec, exhibit a flatter pharmacological curve with no obvious peak value, and less within-subject variation is noted compared with NPH [14,79]. Furthermore, irrespective of kidney function, compared with glargine U300, insulin degludec has a reduction in HbA1c from baseline and a lower total daily insulin dose [80]. Rapid-acting insulin analogs have a quicker onset and peak and shorter duration of action, and are not prone to hypoglycemia before the next meal compared with regular human insulin [58,60,81,82].…”

Section: Duke University Medical Centermentioning

confidence: 99%

Insulin therapy in diabetic kidney disease

Liu

Zhao

Xiong

et al. 2021

Diabetic Nephropathy

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Diabetic kidney disease (DKD) is the main cause of end-stage renal disease (ESRD). The use of insulin represents a challenge in patients with DKD due to the patient and medication issues. Insulin regimens, insulin dosing, and titration need to be individualized based on the patient's age, renal function, and comorbidities to improve glycemic control and reduce the risk of hypoglycemia. Insulin is the primary treatment in all patients with type 1 diabetes mellitus (T1DM) and DKD. For patients with type 2 diabetes mellitus (T2DM) and early stage of DKD, basal insulin combined with oral antidiabetic drugs (OADs) is recommended. In patients with middle and advanced DKD, it is necessary to adjust the dose of insulin according to stages of DKD, and the use of insulin analogs is recommended. In particular, elderly patients with DKD can simplify their insulin regimen to reduce the risk of hypoglycemia. In pregnant women with DKD, insulin requirements also vary based on parity and the stage of pregnancy.

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