Original paper: Efficacy and safety analysis of insulin degludec/insulin aspart compared with biphasic insulin aspart 30: A phase 3, multicentre, international, open-label, randomised, treat-to-target trial in patients with type 2 diabetes fasting during Ramadan

Abstract

IDegAsp is a suitable therapeutic agent for patients who need insulin for sustained glucose control before, during and after Ramadan fasting, with a significantly lower risk of hypoglycaemia, versus BIAsp 30, an existing premixed insulin analogue.

Diabetes Canada Position Statement for People With Types 1 and 2 Diabetes Who Fast During Ramadan

“…A recent open-label treat-to-target trial randomized 263 subjects from 5 different countries to twice-daily insulin degludecaspart combination (not available in Canada) or biphasic insulin aspart 30. The degludec-aspart combination had significantly lower rates of overall and nocturnal hypoglycemia, with similar A1C efficacy (32). In this trial, the insulin dosage adjustment pre-Ramadan was in tandem with the IDF-DAR recommendations (8).…”

Ramadan and Diabetes: A Narrative Review and Practice Update

“…Earlier research also supports the greater risk of hypoglycaemia with SUs compared metformin monotherapy [62]. A number of studies have also shown the lower risk of hypoglycaemia with newer T2 diabetes therapies compared to SUs and their safety in Ramadan fasting [58,59,[63][64][65][66][67][68][69][70][71].…”

“…Second-generation insulins may offer less glycaemic variability and hypoglycaemia and hence have a potential for use in Ramadan. The combination of insulin degludec/degludec and aspart insulin (IDegAsp) has been shown to be a safe and efficacious therapy during Ramadan [ 64 , 140 ]. In a recent real-world observational study, patients with T2 diabetes fasting in Ramadan who were taking insulin glargine 300 units/ml showed a low risk of severe/symptomatic hypoglycaemia and improved control [ 141 ].…”

The Clinical Role of Insulin Degludec/Insulin Aspart in Type 2 Diabetes: An Empirical Perspective from Experience in Australia

“…In a randomised treat-to-target trial, IDegAsp BID provided sustained glucose control before, during and after Ramadan fasting in patients with T2D previously treated with basal or premixed insulin ± OADs, with a significantly lower risk of hypoglycaemia than BIAsp 30 BID [62]. Doses of IDegAsp BID and BIAsp 30 BID were reduced by 30%-50% on the first day of Ramadan and readjusted to pre-Ramadan levels at the end of Ramadan.…”