Efficacy and Safety of Insulin Degludec/Insulin Aspart Compared with a Conventional Premixed Insulin or Basal Insulin: A Meta-Analysis

Moon, Shinje; Chung, Hye-Soo; Kim, Yun Joong; Yu, Jaemyung; Jeong, Wooju; Park, Ji Won; Oh, Chang‐Myung

doi:10.3390/metabo11090639

Cited by 4 publications

(7 citation statements)

References 37 publications

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“…19 The reduction in FPG with IDegAsp could be attributed to the long-acting effect of the IDeg analog while HbA1c reduction may be due to the prandial coverage of the IAsp analog. 17 The doses of total daily, prandial and basal insulin were reduced from baseline to EOS in this study; however, these reductions were not statistically significant. A similar trend was observed in a retrospective real-world study in Japan where there was a significant reduction (p<0.0001) in daily basal insulin dose over 26 weeks in patients with T2DM who were administered with IDegAsp.…”

Section: Insulin Dosecontrasting

confidence: 59%

“…20 Also, nine studies in the meta-analysis reported a reduction or no difference in total dose requirement for IDegAsp compared to other basal insulins. 17 In our study, the incidence of overall and nocturnal nonsevere and severe hypoglycemic events was reduced from baseline to EOS. Although the low number of hypoglycemic events did not allow for statistical comparisons, these results suggest that improvement in glycemic control can be achieved with IDegAsp potentially without increased risk of hypoglycemia.…”

Section: Insulin Dosementioning

confidence: 42%

“…In a meta-analysis, nocturnal hypoglycemia was significantly reduced with IDegAsp. 17 initiation, eight patients reported having missed workdays due to diabetes and its complications, while none of the patients reported missed workdays after treatment initiation in the Malaysian cohort.…”

Section: Insulin Dosementioning

confidence: 83%

“…Likewise, the daily basal insulin premixed insulin BID; however, both insulin types had a similar effect on HbA1c levels. 17 In another metaanalysis of six RCTs including 1346 patients with T2DM, a significant decrease in mean HbA1c was reported with IDegAsp OD compared with insulin glargine (IGlar) OD. 18 In another retrospective observational study, IDegAsp OD led to significantly lower HbA1c levels and FPG than basal insulin in 87 patients with T2DM in each treatment group.…”

Section: Insulin Dosementioning

confidence: 98%

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Initiating or Switching to Insulin Degludec/Insulin Aspart in Adults with Type 2 Diabetes in Malaysia: Results from a Prospective, Non-Interventional Real-World Study

Mohamed

Lim

Mumtaz

et al. 2023

JAFES

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Objectives. Insulin degludec (IDeg)/insulin aspart (IAsp; IDegAsp) is a co-formulation of 70% IDeg and 30% IAsp. According to several randomized controlled trials, IDegAsp is effective and safe for patients with type 2 diabetes mellitus (T2DM). A subgroup analysis of the ARISE study was conducted to explore the safety and efficacy of IDegAsp among Malaysian patients with T2DM in real-world settings.Methodology. ARISE, an open-label, multicenter, non-interventional, prospective study was conducted between August 2019 and December 2020. Adult Malaysian patients with T2DM who were enrolled from 14 sites received IDegAsp as per the local label for 26 weeks. The primary endpoint was change in glycated hemoglobin (HbA1c) levels from baseline to end of study (EOS).Results. Of the 182 patients included in the full analysis set, 159 (87.4%) completed the study. From baseline to EOS, HbA1c (estimated difference [ED]: -1.3% [95% CI: -1.61 to -0.90]) and fasting plasma glucose levels (ED: -1.8 mmol/L [95% CI: -2.49 to -1.13]) were significantly reduced (p<0.0001). The patient-reported reduced hypoglycemic episodes (overall and nocturnal) during treatment. Overall, 37 adverse events were observed in 23 (12.6%) patients.Conclusion. Switching or initiating IDegAsp treatment resulted in significant improvements in glycemic control and a reduction in hypoglycemic episodes.

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Section: Insulin Dosecontrasting

confidence: 59%

Section: Insulin Dosementioning

confidence: 42%

Section: Insulin Dosementioning

confidence: 83%

Section: Insulin Dosementioning

confidence: 98%

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Initiating or Switching to Insulin Degludec/Insulin Aspart in Adults with Type 2 Diabetes in Malaysia: Results from a Prospective, Non-Interventional Real-World Study

Mohamed

Lim

Mumtaz

et al. 2023

JAFES

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“…22 A MA published in 2021 showed that once-daily IDegAsp is associated with comparable glycaemic control, but a lower risk of nocturnal hypoglycaemia compared with once-daily basal insulins. 23 Both Gla-300 and IDegAsp are approved in several countries, but there is no head-to-head trial comparing them. Therefore, we conducted an SLR and ITC to compare the efficacy and safety of Gla-300 to IDegAsp in patients with T2D inadequately controlled on OADs.…”

Section: Discussionmentioning

confidence: 99%

Comparative efficacy and safety of Gla‐300 versus IDegAsp in insulin‐naïve people with type 2 diabetes mellitus uncontrolled on oral anti‐diabetics

Ritzel

Ghosh

Emral

et al. 2023

Diabetes Obesity Metabolism

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Aim: To compare the efficacy and safety of insulin glargine-300 once daily (Gla-300) with insulin degludec/aspart (IDegAsp) once daily in patients with type 2 diabetes (T2D) inadequately controlled on oral anti-diabetic drugs (OADs). Materials and methods:A systematic literature review of randomized controlled trials was followed by an indirect treatment comparison of studies involving insulin naïve adults, inadequately controlled [glycated haemoglobin (HbA1c) ≥7.0%] on OADs, who received Gla-300 or IDegAsp once daily. Outcomes of interest were change in HbA1c, blood glucose, weight and insulin dose, as well as incidence and event rate of hypoglycaemia and other adverse events.Results: Four trials with broadly similar baseline patient characteristics were included in the meta-analyses and indirect treatment comparison. At 24-28 weeks, the indirect comparison of Gla-300 to IDegAsp once daily estimated no statistically significant difference for change in HbA1c (%) from baseline [mean difference of 0.10% (95% CI: À0.20, 0.39; p = .52)]; a statistically significant mean difference of À1.31 kg (95% CI: À1.97, À0.65; p < .05) for change in body weight from baseline; statistically significant odds ratios of 0.62 (95% CI: 0.41, 0.93; p < .05) for incidence of any hypoglycaemia; and 0.47 (95% CI: 0.25, 0.87; p < .05) for incidence of anytime confirmed hypoglycaemia (plasma glucose <3.0-3.1 mmol/L). No significant differences were observed for insulin dose and adverse events. Conclusion:In insulin-naïve patients with T2D inadequately controlled on OADs, commencing Gla-300 shows a comparable HbA1c reduction, but with significantly less weight gain and a lower incidence of any and confirmed hypoglycaemia compared with commencing IDegAsp.

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Comparison of Insulin Analogs and Human Insulins: A Narrative Review

Eledrisi,

Danjuma

2023

Journal of Diabetes and Endocrine Practice

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Introduction Since insulin analogs have pharmacological properties that are similar to the normal physiological action of insulin, it has been suggested that they provide better glucose control and less rates of hypoglycemia compared to human insulins. Methods We performed a narrative, nonsystematic review of the literature including clinical trials, systematic reviews, meta-analyses, and professional guidelines related to the comparison of human insulins and insulin analogs in terms of glucose control, safety profile, and cost. Results Long-acting basal insulins result in mild improvement in glucose control and less rates of nocturnal hypoglycemic compared to neutral protamine Hagedorn insulin, mainly among patients with type 1 diabetes. Rapid-acting insulin analogs provide better glucose control and lower rates of hypoglycemia compared to regular insulin among patients with type 1 diabetes, whereas no advantage has been shown for insulin analogs among patients with type 2 diabetes for glucose control or hypoglycemia. Premixed insulin analogs provided no advantage in glucose control and inconsistent benefit in lowering the rates of hypoglycemia compared to human premixed insulins among patients with type 2 diabetes. The cost of insulin analogs is significantly higher than human insulins, and favorable cost-effectiveness has only been demonstrated for rapid-acting insulin analogs in type 1 diabetes. Conclusion Currently available evidence supports the use of rapid-acting insulin analogs and possibly long-acting basal insulin over human insulins for patients with type 1 diabetes. For patients with type 2 diabetes, the use of long-acting insulin analogs may be recommended for selected patients who are at an increased risk of significant hypoglycemia, while no clear benefits of meal insulin analogs over human insulins have been observed.

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Efficacy and Safety of Insulin Degludec/Insulin Aspart Compared with a Conventional Premixed Insulin or Basal Insulin: A Meta-Analysis

Cited by 4 publications

References 37 publications

Initiating or Switching to Insulin Degludec/Insulin Aspart in Adults with Type 2 Diabetes in Malaysia: Results from a Prospective, Non-Interventional Real-World Study

Initiating or Switching to Insulin Degludec/Insulin Aspart in Adults with Type 2 Diabetes in Malaysia: Results from a Prospective, Non-Interventional Real-World Study

Comparative efficacy and safety of Gla‐300 versus IDegAsp in insulin‐naïve people with type 2 diabetes mellitus uncontrolled on oral anti‐diabetics

Comparison of Insulin Analogs and Human Insulins: A Narrative Review

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