Insulin degludec compared with insulin glargine in insulin‐naïve patients with type 2 diabetes: <scp>A</scp> 26‐week, randomized, controlled, <scp>P</scp>an‐<scp>A</scp>sian, treat‐to‐target trial

Onishi, Yukiko; Iwamoto, Yasuhiko; Yoo, Soon Jib; Clauson, Per; Tamer, Søren Can; Park, Sung Woo

doi:10.1111/jdi.12102

Cited by 98 publications

(167 citation statements)

References 28 publications

Supporting

Mentioning

143

Contrasting

Unclassified

Order By: Relevance

“…Insulin degludec and insulin glargine reduced HbA1c by 1.1 and 1.2%-points, (∼12 and 13 mmol/mol) respectively (NS), at similar mean daily insulin doses (1.46 and 1.42 U/kg, respectively). Overall confirmed hypoglycaemia occurred at a lower rate with insulin degludec than insulin glargine (11.09 vs. 13.63 episodes/patientyear, 18% rate reduction, p = 0.0359), as was also the case for nocturnal confirmed hypoglycaemia (1.39 vs. 1.84 episodes/patient-year, 25% rate reduction, p = 0.0399).Reduced rates of hypoglycaemia have also been reported in studies comparing insulin degludec with insulin glargine as basal-only insulin initiation in type 2 diabetes [42,43]. For example, in a 52-week trial, 1030 insulin-naïve adults were randomized (3 : 1) to add once-daily insulin degludec or insulin glargine to metformin with or without DPP-4 inhibitor [42].…”

mentioning

confidence: 58%

Will the next generation of basal insulins offer clinical advantages?

Garber

2013

Diabetes Obesity Metabolism

View full text Add to dashboard Cite

The 21st century has seen the arrival of several insulin analogue products and the refinement of insulin regimens, with widespread advocacy of continuous titration algorithms and earlier initiation of supplementary insulin therapy (predominantly using basal insulins) in type 2 diabetes. Nevertheless, many insulin-treated diabetes patients remain in poor glycaemic control. This might reflect insufficient titration effort or lax adherence, but these issues could in some cases result from concerns about hypoglycaemia. Certainly there is scope for improving the pharmacokinetic/pharmacodynamic (PK/PD) profile of basal insulin, and three new products offer this prospect. Insulin degludec, now in clinical use, and PEGylated insulin lispro, in development, have greatly extended action profiles that result from two very different, but unique, mechanisms. With once-daily dosing, these insulins produce stable PK/PD profiles at steady state, associated with a low incidence of hypoglycaemia. The feasibility of varied daily dose timing has also been confirmed with insulin degludec. High strength formulations of insulin glargine and insulin degludec offer the prospect of a reduced injection number/volume in high dose users, and in the case of glargine, the PK/PD profile might also be favourably modified. This review considers critically the clinical evidence and expectations we should have for these new basal insulins. Keywords: basal insulin, diabetes, insulin degludec, pegylated insulin lispro, U300 glargine Date submitted 9 September 2013; date of first decision 29 September 2013; date of final acceptance 29 September 2013 Why do we Need Better Basal Insulins?Basal insulins are used in patients with type 1 diabetes in basalbolus therapy and are now widely used in patients with type 2 diabetes either as basal-bolus or basal plus oral anti-diabetic drug (OAD) regimens. Unfortunately, despite the availability of insulin analogues and improved education for patients and their healthcare providers, the likelihood of achieving good glycaemic control according to recent guidelines remains discouragingly low [1,2]. Globally, poor glycaemic control is highly prevalent with 44-63% of patients not achieving glycaemic targets in Latin America, Europe, Asia and the United States [3][4][5][6]. Since such poor control ultimately results in the early appearance of vascular complications, the cost of diabetes care is escalating rapidly worldwide.Many factors including regimen complexity, injection frequency and weight gain can impede a patient's ability to manage and control their blood glucose levels, and hypoglycaemia (or fear of it) is widely perceived as a principal limiting factor in the success of insulin therapy. Acutely, mild hypoglycaemia causes unpleasant and distressing adrenergic symptoms for patients who, as a consequence, practice avoidance behaviours. On occasion severe hypoglycaemia occurs, which can result in fatal or non-fatal cardiovascular Correspondence to: Alan J Garber, MD PhD, Professor of Medicine, Biochemistry and ...

show abstract

mentioning

confidence: 58%

Will the next generation of basal insulins offer clinical advantages?

Garber

2013

Diabetes Obesity Metabolism

View full text Add to dashboard Cite

show abstract

“…In the 26-week, open-label BEGIN Once Asia study, patients were treated with either IDeg or Gla-100 QD, with a titration target of blood glucose ~70-90 mg/dl (3.9-5.0 mmol/l) [49]. There were no significant differences in rates of confirmed overall or nocturnal hypoglycemia over the trial period (Table 1).…”

Section: Hypoglycemia In T2dmmentioning

confidence: 99%

Hypoglycemia with New Generation Basal Analog Insulins: A Descriptive Critical Review

Thrasher¹

2015

J Diabetes Metab

View full text Add to dashboard Cite

Optimizing the treatment of people with diabetes relies on balancing the benefits of glycemic control with the risk of hypoglycemia. Although insulin is essential for treating patients with type 1 diabetes mellitus, patient and physician concerns regarding an increased risk of hypoglycemia can lead to delays in initiating insulin treatment in patients with type 2 diabetes mellitus. This clinical inertia contributes to reduced glycemic control and poorer outcomes for patients. Advances in insulin agents have reduced the risk of hypoglycemia. In particular, the introduction of insulin glargine, the first basal analog insulin with a 24-hour glucose-lowering profile with no pronounced peak, represented a significant step towards achieving this goal.To further improve patient management, a number of insulin formulations and molecules are in development and are designed to have pharmacokinetic/pharmacodynamic (PK/PD) profiles allowing closer mimicking of normal physiologic insulin release. Here we review these new agents, and discuss their hypoglycemic risk as reported in clinical trials. In addition, the difficulties in making comparative evaluations from studies with different patient populations and definitions of hypoglycemia are discussed. Solutions to improve future clinical trials are suggested. In general, the improved PK/PD profiles of new-generation insulins appear to result in better clinical outcomes in terms of hypoglycemia. What is needed are head-to-head trials using standardized methods and criteria to allow clinicians to compare hypoglycemia rates between insulins, and help them to discuss appropriate choices of therapy with their patients.

show abstract

“…Все исследова-ния продемонстрировали, что деглудек при однократном введении по эффективности снижения HbA 1c (первич-ная конечная точка) не уступает препарату сравнения (табл. 1), при использовании в одинаковых или даже более низких дозах [31][32][33][34][35][36][37].…”

Section: эффективность нового базального инсулинаunclassified

“…Не лишним будет также отметить, что все преи-му щества инсулина деглудек, продемонстрированные в ходе клинических исследований при СД2, характерны как для европеоидной, так и монголоидной (азиатской) расы [36]. Последнее характеризуется не только особенно-стями питания и образа жизни, но и патофизиологией СД.…”

Section: эффективность нового базального инсулинаunclassified

Insulin degludec is a new ultra-long-acting insulin analogue

et al. 2014

View full text Add to dashboard Cite

Сахарный диабетДиагностика, контроль и лечение есмотря на большое количество лекарственных препаратов, одобренных для лечения сахарного диабета (СД), инсулинотерапия по-прежнему остается наиболее эффективным вариантом терапии СД 2 типа (СД2) и единственным патогенетически обосно-ванным и жизненно необходимым методом лечения СД 1 типа (СД1) [1]. Более того, в последние годы показания к инсулинотерапии при СД2 значительно расширились. По данным Британского проспективного исследования UKPDS (United Kingdom Prospective Diabetes Study), еже-годно в назначении инсулина нуждаются 5-10% пациен-тов с впервые диагностированным СД2, а спустя 10 лет большинству пациентов для достижения и поддержания целевых параметров гликемического контроля требуется постоянная инсулинотерапия [2]. Раннее и обоснованное назначение инсулинотерапии является основным факто-ром, способствующим длительному поддержанию целе-вых параметров гликемического контроля, способствует снижению частоты микро-и макрососудистых осложне-ний диабета [3][4][5]

show abstract

Insulin degludec compared with insulin glargine in insulin‐naïve patients with type 2 diabetes: A 26‐week, randomized, controlled, Pan‐Asian, treat‐to‐target trial

Abstract: Introduction: Insulin degludec (IDeg) is an ultra-long-acting basal insulin with a consistent action profile of >42 h. This trial compared the efficacy and safety of IDeg with insulin glargine (IGlar) in insulin-na€ ıve Asian patients with type 2 diabetes.

Cited by 98 publications

References 28 publications

Will the next generation of basal insulins offer clinical advantages?

Will the next generation of basal insulins offer clinical advantages?

Hypoglycemia with New Generation Basal Analog Insulins: A Descriptive Critical Review

Insulin degludec is a new ultra-long-acting insulin analogue

Contact Info

Product

Resources

About