Effect of Insulin Degludec vs Insulin Glargine U100 on Hypoglycemia in Patients With Type 1 Diabetes

Lane, Wendy; Bailey, Timothy S.; Gerety, Gregg; Gumprecht, Janusz; Philis‐Tsimikas, Athena; Hansen, Charlotte T.; Nielsen, Thomas Theis; Warren, Mark

doi:10.1001/jama.2017.7115

Cited by 194 publications

(216 citation statements)

References 23 publications

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“…Specifically, the daily dose of the IDeg component of IDegAsp was 26% lower than that of IDet in the comparator arm and the total daily dose of insulin was 15% lower with IDegAsp + IAsp vs IDet + IAsp. This is in agreement with previous results from treat‐to‐target trials, which demonstrated a lower end‐of‐trial daily insulin dose requirement with IDeg vs IDet and vs insulin glargine 100 units/mL (IGlar U100) and with IGlar U100 vs IDet …”

Section: Discussionsupporting

confidence: 93%

Efficacy and safety of a fixed combination of insulin degludec/insulin aspart in children and adolescents with type 1 diabetes: A randomized trial

et al. 2018

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Section: Discussionsupporting

confidence: 93%

Efficacy and safety of a fixed combination of insulin degludec/insulin aspart in children and adolescents with type 1 diabetes: A randomized trial

et al. 2018

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“…Degludec is associated with tolerability and overall glycaemic control similar to other long‐acting insulin analogues, with the benefit of a reduced rate of overall symptomatic hypoglycaemic and severe hypoglycaemic events,21, 22, 23 which may have contributed to the lower rates of hypoglycaemia observed here compared with observations during the onset 1 study 14. In addition, in the present study, an improvement in glycaemic control, that is, a reduction in HbA1c of approximately 0.6% in each arm, was achieved with weekly titration of degludec (pre‐breakfast target, 4.0–5.0 mmol/L) over the eight‐week run‐in period.…”

Section: Discussionmentioning

confidence: 99%

Fast‐acting insulin aspart versus insulin aspart in the setting of insulin degludec‐treated type 1 diabetes: Efficacy and safety from a randomized double‐blind trial

Buse¹,

Carlson²,

Komatsu

et al. 2018

Diabetes Obesity Metabolism

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AimTo evaluate the efficacy and safety of mealtime or post‐meal fast‐acting insulin aspart (faster aspart) vs mealtime insulin aspart (IAsp), both in combination with insulin degludec, in participants with type 1 diabetes (T1D).MethodsThis multicentre, treat‐to‐target trial (Clinical trial registry: NCT02500706, http://clinicaltrials.gov) randomized participants to double‐blind mealtime faster aspart (n = 342) or IAsp (n = 342) or open‐label post‐meal faster aspart (n = 341). The primary endpoint was change from baseline in HbA1c 26 weeks post randomization. All available information, regardless of treatment discontinuation, was used for evaluation of the effect.ResultsNon‐inferiority for the change from baseline in HbA1c was confirmed for mealtime and post‐meal faster aspart vs IAsp (estimated treatment difference [ETD]: 95%CI, −0.02% [−0.11; 0.07] and 0.10% [0.004; 0.19], respectively). Mealtime faster aspart was superior to IAsp for 1‐hour PPG increment using a meal test (ETD, −0.90 mmol/L [−1.36; –0.45]; P < 0.001). Self‐monitored 1‐hour PPG increment favoured faster aspart at breakfast (ETD, −0.58 mmol/L [−0.99; −0.17]; P = 0.006) and across all meals (−0.48 mmol/L [−0.74; −0.21]; P < 0.001). Safety profiles and overall rate of severe or blood glucose‐confirmed hypoglycaemia were similar between treatments, but significantly less hypoglycaemia was seen 3 to 4 hours after meals with mealtime faster aspart.ConclusionMealtime and post‐meal faster aspart in conjunction with insulin degludec provided effective glycaemic control compared with IAsp, with no increased safety risk. Mealtime faster aspart provided PPG control superior to that of IAsp.

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“…These analogs are associated with less hypoglycemia, less weight gain, and lower A1C than human insulins in people with type 1 diabetes (16-18). Longer-acting basal analogs (U-300 glargine or degludec) may additionally convey a lower hypoglycemia risk compared with U-100 glargine in patients with type 1 diabetes (19,20).…”

Section: Insulin Therapymentioning

confidence: 99%

8. Pharmacologic Approaches to Glycemic Treatment: Standards of Medical Care in Diabetes—2018

2017

Diabetes Care

632

315

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The American Diabetes Association (ADA) “Standards of Medical Care in Diabetes” includes ADA’s current clinical practice recommendations and is intended to provide the components of diabetes care, general treatment goals and guidelines, and tools to evaluate quality of care. Members of the ADA Professional Practice Committee, a multidisciplinary expert committee, are responsible for updating the Standards of Care annually, or more frequently as warranted. For a detailed description of ADA standards, statements, and reports, as well as the evidence-grading system for ADA’s clinical practice recommendations, please refer to the Standards of Care Introduction. Readers who wish to comment on the Standards of Care are invited to do so at professional.diabetes.org/SOC.

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Effect of Insulin Degludec vs Insulin Glargine U100 on Hypoglycemia in Patients With Type 1 Diabetes

Abstract: clinicaltrials.gov Identifier: NCT02034513.

Cited by 194 publications

References 23 publications

Efficacy and safety of a fixed combination of insulin degludec/insulin aspart in children and adolescents with type 1 diabetes: A randomized trial

Efficacy and safety of a fixed combination of insulin degludec/insulin aspart in children and adolescents with type 1 diabetes: A randomized trial

Fast‐acting insulin aspart versus insulin aspart in the setting of insulin degludec‐treated type 1 diabetes: Efficacy and safety from a randomized double‐blind trial

8. Pharmacologic Approaches to Glycemic Treatment: Standards of Medical Care in Diabetes—2018

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