Medium-Term Effects of Insulin Degludec on Patients with Type 1 Diabetes Mellitus

Nakae, Rie; Kusunoki, Yoshiki; Katsuno, Tomoyuki; Tokuda, Masaru; Akagami, Takafumi; Murai, Kazuki; Hamaguchi, Tomoya; Miyagawa, Jun‐ichiro; Namba, Mitsuyoshi

doi:10.1007/s40268-014-0048-6

Cited by 7 publications

(8 citation statements)

References 13 publications

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“…Consistent with our findings, patients required a lower daily dose of Deg compared to their prior insulin dose and the required dose of basal insulin decreased significantly 24 weeks after switching. However, the improvement in MAGE that we report here was not observed in this previous study [10]. The reason for the discrepancy in CGM data is unclear, but may be due to the differences in the number of participants or the inclusion of hospitalized patients in the current study whose diet and activity were closely monitored.…”

Section: Insulin Dose (Table 2)contrasting

confidence: 84%

“…Recently, the same group has published two reports assessing the effects of Deg and Gla using CGM with a test diet [9,10]. Patients with type 1 diabetes were switched from Gla or detemir to Deg and followed for 12 or 24 weeks.…”

Section: Insulin Dose (Table 2)mentioning

confidence: 99%

“…Although the phase 3 trials of Deg showed good performance as a new basal insulin in people with type 1 diabetes [6][7][8], few studies have shown the effect of Deg on the stability of glucose levels using continuous glucose monitoring (CGM) [9,10]. CGM systems allow visualization of the daily variations in blood glucose levels, facilitating the detection of postprandial hyperglycemia and asymptomatic hypoglycemia.…”

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confidence: 99%

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Degludec is superior to glargine in terms of daily glycemic variability in people with type 1 diabetes mellitus

et al. 2016

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Section: Insulin Dose (Table 2)contrasting

confidence: 84%

Section: Insulin Dose (Table 2)mentioning

confidence: 99%

mentioning

confidence: 99%

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Degludec is superior to glargine in terms of daily glycemic variability in people with type 1 diabetes mellitus

et al. 2016

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“…After switching, the glycemic control was improved in all types of patients. In previous studies 7,9 , when participants were switched to IDeg, the basal insulin dose was adjusted, and dose reduction was greater in these reports than in the present study. Such greater dose reduction might be one of the reasons for unimproved glycemic control for participants that switched to IDeg in the previous studies 7,9 .…”

Section: Discussioncontrasting

confidence: 47%

“…In previous studies 7,9 , when participants were switched to IDeg, the basal insulin dose was adjusted, and dose reduction was greater in these reports than in the present study. Such greater dose reduction might be one of the reasons for unimproved glycemic control for participants that switched to IDeg in the previous studies 7,9 . Therefore, our finding suggested that smaller basal insulin dose reduction might provide better glycemic control when patients with difficult glycemic control using IGlar or IDet were transferred to IDeg.…”

Section: Discussioncontrasting

confidence: 47%

A 1‐year, prospective, observational study of Japanese outpatients with type 1 and type 2 diabetes switching from insulin glargine or detemir to insulin degludec in basal–bolus insulin therapy (Kumamoto Insulin Degludec Observational study)

Shimoda

Sato

Sekigami

et al. 2016

J of Diabetes Invest

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Aims/IntroductionThe aim of the present prospective observational study was to assess long‐term efficacy and safety of insulin degludec as a part of a basal–bolus therapy for Japanese patients with type 1 or type 2 diabetes in routine clinical practice.Materials and MethodsIn the present study, 93 type 1 diabetes patients and 135 type 2 diabetes patients treated with insulin glargine or detemir were switched from their basal insulin to insulin degludec. The primary end‐points were the changes in glycated hemoglobin (HbA1c) from baseline at 3, 6 and 12 months. The secondary end‐points were changes in body mass index, insulin dose, frequency of hypoglycemia and adverse events.ResultsHbA1c levels from baseline were significantly reduced at 3, 6, and 12 months by 0.4, 0.4 and 0.3% in type 1 diabetes patients, respectively, and by 0.5, 0.5 and 0.3% in type 2 diabetes patients, respectively. Body mass index in type 1 diabetes patients increased significantly (P < 0.05), whereas that in type 2 diabetes patients did not change. Basal insulin dose decreased significantly at 3 months after switching (P < 0.05), and returned baseline dose at 12 months in type 1 diabetes and type 2 diabetes patients. The frequency of both total and nocturnal hypoglycemia decreased significantly in type 1 diabetes and type 2 diabetes patients (P < 0.05). The result of multiple regression analysis showed that baseline HbA1c was a significant independent variable of the percentage change in HbA1c with switching.ConclusionIn both type 1 diabetes and type 2 diabetes patients, switching from insulin glargine or insulin detemir to insulin degludec led to improvement of glycemic control with a significant reduction of hypoglycemia.

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Insulin Degludec in Clinical Practice: A Review of Japanese Real-World Data

et al. 2017

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IntroductionIn this literature review we evaluated the real-world clinical effectiveness of switching Japanese diabetic patients from their current insulin regimen to insulin degludec (IDeg).MethodsStudies were identified from Japanese Diabetes Society (JDS) abstracts (2014–2015) and PubMed (2012 onwards). Inclusion criteria were: Japanese population, >15 participants, and studies switching patients from basal or basal–bolus insulin regimens to IDeg. Randomized controlled trials and case reports were excluded. Weighted mean changes in safety and effectiveness endpoints were calculated using the number of patients in each study.ResultsIn total, 81 JDS abstracts and seven manuscripts met the search criteria, representing 4238 patients [1028 with type 1 diabetes (T1D), 602 with type 2 diabetes (T2D), 2608 with unspecified or mixed diabetes]. Glycated hemoglobin (HbA1c) was reported in 93% of studies, with an improvement in 84% of these (51% significant, 33% numerical), no change in 12%, and worsening in 4% (3% numerical, 1% significant). Across all studies, the weighted mean absolute change in HbA1c was −0.3% (−2.7 mmol/mol). Basal insulin dose was reported in 58% of studies and was lower in 60% of these (30% significant, 30% numerical), numerically unchanged in 26%, and higher in 14% (2% significant, 12% numerical). The weighted mean change in basal insulin dose was −4.8% and −3.0% for all studies and for studies with only significant results, respectively. The weighted mean change in basal dose based on all studies was −8.9, −5.5, and −2.9% for the T1D, T2D, and unspecified patient populations, respectively. Hypoglycemia was recorded in 31% of the studies. After switching treatment to IDeg, 55% of studies reported decreased hypoglycemia, 29% no change, and 16% an increase. Quality of life (QoL) was measured in 11% of studies, of which 82% reported improved QoL after switching, and 18% reported no change in QoL.ConclusionSwitching from a conventional basal insulin to IDeg has the potential to improve HbA1c with a lower insulin dose. Switching to IDeg may also provide a reduced risk of hypoglycemia and improvement in QoL.FundingNovo Nordisk.Electronic supplementary materialThe online version of this article (doi:10.1007/s13300-017-0225-z) contains supplementary material, which is available to authorized users.

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Medium-Term Effects of Insulin Degludec on Patients with Type 1 Diabetes Mellitus

Cited by 7 publications

References 13 publications

Degludec is superior to glargine in terms of daily glycemic variability in people with type 1 diabetes mellitus

Degludec is superior to glargine in terms of daily glycemic variability in people with type 1 diabetes mellitus

A 1‐year, prospective, observational study of Japanese outpatients with type 1 and type 2 diabetes switching from insulin glargine or detemir to insulin degludec in basal–bolus insulin therapy (Kumamoto Insulin Degludec Observational study)

Insulin Degludec in Clinical Practice: A Review of Japanese Real-World Data

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