Insulin degludec allows for better glycaemic control with a lower risk of hypoglycaemia in patients with chronic kidney disease and type 2 diabetes

The role of basal insulins in the treatment of people with type 2 diabetes and chronic kidney disease: A narrative review

“…59 Similarly, a retrospective analysis in people with T2D and Stage 2-3B CKD who switched to iDeg from any other long-acting BI concluded that iDeg was associated with a reduced risk of hypoglycaemia and improved glycaemic control. 65 The REALI pooled database documented improvements in glycaemic control, without undue safety concerns, with the initiation of Gla-300 in people with T2D and reduced kidney function. 60 A subanalysis of the ATOS observational study showed that initiation of Gla-300 is similarly effective in those with renal impairment as in those without, in terms of HbA1c reduction target achievement.…”

“…In the DELIVER‐High Risk US retrospective study, switching from a first‐generation BI analogue (Gla‐100 or insulin detemir) to the second‐generation analogue Gla‐300 in people with T2D and moderate‐to‐severe renal impairment (n = 861) was associated with reduced incidence and rate of hypoglycaemia, versus switching to a different first‐generation analogue (Gla‐100 or insulin detemir) 59 . Similarly, a retrospective analysis in people with T2D and Stage 2‐3B CKD who switched to iDeg from any other long‐acting BI concluded that iDeg was associated with a reduced risk of hypoglycaemia and improved glycaemic control 65 . The REALI pooled database documented improvements in glycaemic control, without undue safety concerns, with the initiation of Gla‐300 in people with T2D and reduced kidney function 60 .…”

Hyperglycaemia in people with diabetes and chronic kidney disease

“…Ved forekomst af hypoglykaemi bør man overveje dosisreduktion eller skift til andet insulinregime. Risikoen for isaer natlig hypoglykaemi kan nedsaettes ved brug af de nye generationer af basalinsulinanaloger (insulin degludec og insulin glargin U100 & U300), som har vist sig sikre i behandlingen af diabetes hos personer med CKD uanset graden [19,[25][26][27]. Ligeledes er det påvist, at hurtigtvirkende (prandial/måltids-) insulinanaloger sammenlignet med humant insulin reducerer forekomsten af hypoglykaemi og giver bedre postprandial glykaemisk kontrol [17].…”