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09.11.2019 | Original Research | Ausgabe 1/2020 Open Access

Diabetes Therapy 1/2020

Switching Patients with Type 1 Diabetes to Insulin Degludec from Other Basal Insulins: Real-World Data of Effectiveness and Safety

Zeitschrift:
Diabetes Therapy > Ausgabe 1/2020
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/​s13300-019-00722-y) 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.​10042994.

Abstract

Introduction

Real-world evidence on the effectiveness and safety of insulin degludec (IDeg) in patients with diabetes is a priority. We have therefore evaluated the effectiveness and safety of IDeg, including impact on metabolic control, glycemic variability, weight gain and hypoglycemia, in patients with type 1 diabetes under routine clinical practice conditions.

Methods

This was an observational longitudinal multicenter study. A retrospective chart review of all patients with type 1 diabetes who were switched from basal insulin to IDeg was performed, and temporal trends in clinical outcomes were assessed.

Results

Data obtained from 195 patients, with a median age of 42.8 [interquartile range (IQR) 24.6–56.4] years and a median diabetes duration of 16 (IQR 10.0–28) years, were analyzed. Median follow-up was 9.5 (IQR 7.7–11.3) months. Improvements were found in glycated hemoglobin (− 0.34%; p  < 0.0001), fasting blood glucose (− 24.82 mg/dL; p  < 0.0001), post-prandial glucose (− 17.23 mg/dL; p  = 0.0009), glycemic variability as indicated by standard deviation of blood glucose (− 5.67 mg/dL; p  < 0.0001) and high blood glucose index (− 3.77; p < 0.0001). Body weight and body mass index remained substantially stable during the follow-up (− 0.18 kg; p = 0.56 and − 0.12; p = 0.42, respectively). Risk of nocturnal hypoglycemia decreased by 52% [incidence rate ratio 0.48; 95% confidence interval (CI) 0.29–0.77] and risk of total hypoglycemic episodes by 41% (incidence ratio 0.59; 95% CI 0.45–0.83). Basal and short-acting insulin doses decreased by − 1.4 and − 3.1 IU, respectively.

Conclusion

Switching patients with type 1 diabetes to IDeg from other basal insulins was associated with relevant improvements in metabolic control and glycemic variability without weight gain; the risk of hypoglycemic episodes also significantly declined.

Funding

Novo Nordisk S.p.A. unconditional grant.
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