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21.09.2018 | Original Research | Ausgabe 6/2018 Open Access

Diabetes Therapy 6/2018

Impact of Insulin Degludec in Type 2 Diabetes: Real-World Data on Effectiveness and Safety

Zeitschrift:
Diabetes Therapy > Ausgabe 6/2018
Autoren:
Paola Ponzani, Cesare Berra, Alessandra Di Lelio, Paola Del Sindaco, Chiara Di Loreto, Francesco Reggiani, Giuseppe Lucisano, Maria Chiara Rossi
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s13300-018-0511-4) contains supplementary material, which is available to authorized users.

Enhanced digital features

To view enhanced digital features for this article go to https://​doi.​org/​10.​6084/​m9.​figshare.​7059281.

Abstract

Introduction

Real-world evidence on effectiveness and safety of insulin degludec (IDeg) in patients with diabetes is a priority. The aim of the study was to evaluate patterns of use and the long-term effectiveness and safety of IDeg in routine clinical practice.

Methods

This was an observational longitudinal study. A retrospective chart review of all patients with type 2 diabetes treated with IDeg was performed and temporal trends in clinical outcomes were assessed. All data was stratified by treatment modality: the switch group consisted of patients already treated with another basal insulin before initiating IDeg; the add-on group consisted of basal insulin-naïve patients.

Results

Overall, 247 patients were analyzed (55 in the add-on group and 192 in the switch group), mean age 67.0 ± 10.9 years ,and diabetes duration 16.3 ± 8.9 years. Median (interquartile range) follow-up was 9.7 (8.0–11.9) months. In the add-on group, improvements were found in glycated hemoglobin (HbA1c) (– 1.68%; p < 0.0001), fasting blood glucose (FBG) (– 64.7 mg/dL; p < 0.0001), post-prandial glucose (PPG) (– 81.1 mg/dl; p < 0.0001), and glycemic variability (i.e., standard deviation of blood glucose) (– 11.6 mg/dl; p = 0.04). Even in the switch group, improvements were found in HbA1c (– 0.57%; p < 0.0001), FBG (– 28.1 mg/dL; p < 0.0001), and PPG (– 22.6 mg/dl; p = 0.001). Body weight increase during the follow-up was not statistically significant vs. baseline in both groups. Benefits on overall, nocturnal, and severe hypoglycemia were found in the switch group.

Conclusion

These real-world data documented that initiating IDeg or switching to IDeg from other basal insulins in type 2 diabetes was associated with significant improvement in metabolic control without significant weight gain; a decrease in the risk of hypoglycemia was observed when switching to IDeg from another basal insulin.
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