Reduced Risk of Hypoglycemia with Insulin Degludec Versus Insulin Glargine in Patients with Type 2 Diabetes Requiring High Doses of Basal Insulin: A Meta-Analysis of 5 Randomized Begin Trials

Rodbard, Helena W.; Gough, Stephen; Lane, Wendy; Korsholm, Lars; Bretler, Ditte-Marie; Handelsman, Yehuda

doi:10.4158/ep13287.or

Cited by 52 publications

(43 citation statements)

References 14 publications

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“…Regarding safety, previous studies have shown that the risk of hypoglycemia particularly nocturnal, is lower with IDeg than with IGla [18][19][20]. This finding has also been reported in Phase III studies on IDeg [22,28,29]. Moreover, IDeg is safer than IGla with respect to frequency of severe hypoglycemia in a long-term study in patients with type 2 diabetes [30].…”

Section: Discussionsupporting

confidence: 62%

Efficacy and safety of insulin degludec U100 and insulin glargine U100 in combination with meal-time bolus insulin in hospitalized patients with type 2 diabetes: an open-label, randomized controlled study

et al. 2019

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The short-term efficacy and safety of insulin degludec U100 (IDeg) in patients with type 2 diabetes have not been reported widely. We compared insulin IDeg and insulin glargine U100 (IGla) for glycemic control and glucose variability in hospitalized patients with type 2 diabetes. In an open-label, multicenter, randomized controlled trial, 74 patients were randomly assigned to either the IDeg (36 patients) or IGla (38 patients) group and were administered with basal-bolus therapy during hospitalization. Following the start of the treatment, on day 11, glucose variability was assessed by continuous glucose monitoring. A fasting blood glucose level of 110 mg/dL and 2-hour postprandial blood glucose level of 180 mg/dL throughout at least one day during the observation period were achieved in 31.3% (10/32) and 30.6% (11/36) of the patients in the IDeg and IGla groups, respectively. The 6-point self-monitoring of blood glucose profiles showed a significant difference between the two groups. On day 7, the intra-day variation was larger in the IDeg group than in the IGla group. The incidence of hypoglycemia or glucose variability was comparable in the two groups. This study suggests that short-term efficacy and safety of IDeg and IGla in patients with type 2 diabetes during the initial phase of basal-bolus therapy were comparable, and these results can help in deciding which treatment to opt for.

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Section: Discussionsupporting

confidence: 62%

Efficacy and safety of insulin degludec U100 and insulin glargine U100 in combination with meal-time bolus insulin in hospitalized patients with type 2 diabetes: an open-label, randomized controlled study

et al. 2019

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“…Previous phase III studies have confirmed the non-inferiority of degludec compared with glargine, and its effective reduction of diurnal and nocturnal hypoglycaemia. 3 The present study demonstrates the sharp reduction achieved in mild and severe hypoglycaemia, as well as the statistically significant alleviation of HbA1c in CKD stage 3B in patients with elevated risk of hypoglycaemia. eGFR remained unchanged, probably in relation to the better control of systolic blood pressure.…”

Section: Degludec Is Effective and Safe In Real-life Treatment For Pasupporting

confidence: 64%

Degludec is effective and safe in real-life treatment for patients with type 2 diabetes mellitus and chronic kidney disease stage 3B

2018

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“…4 In addition, some patients with T2DM may have higher insulin requirements particularly if they are overweight or obese. [5][6][7] Excess body weight is known to be a major contributor to insulin resistance, 8 and as insulin resistance worsens, exogenous insulin requirements increase. 9 Published real-life data from retrospective, [10][11][12] prospective observational, 13,14 and noninterventional studies 15 have identified patients with T2DM who report using more than 20 units of mealtime insulin per day.…”

mentioning

confidence: 99%

Attributes Influencing Insulin Pen Preference Among Caregivers and Patients With Diabetes Who Require Greater Than 20 Units of Mealtime Insulin

Wang

Conrad

Brunt

et al. 2016

J Diabetes Sci Technol

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Background: This study compared patient preference for Humalog® KwikPen™ 200 units/mL (insulin lispro; hereafter, IL 200 pen; Eli Lilly and Company, Indianapolis, IN) versus the Humalog KwikPen 100 units/mL (insulin lispro; hereafter, IL 100 pen; Eli Lilly and Company, Indianapolis, IN) in patients with diabetes requiring >20 units of mealtime insulin and diabetes caregivers. This study also determined which attributes had the greatest influence on pen preference selection. Methods: In this 2-period, crossover, simulated-use study, 106 participants were randomized to 1 of 8 sequences that varied the pen order (IL 100 pen or IL 200 pen) and dosing order (15 units = low dose or 50 units = high dose) for a total of 4 simulated injections. Participants then completed a self-administered questionnaire to select their overall preference between the 2 pens and then rated the importance of 11 pen attributes in contributing to their overall preference. Results: Of the 90 participants expressing an overall preference, significantly more preferred the IL 200 pen to the IL 100 pen (IL 200 pen: 80 respondents; IL 100 pen: 10 respondents; 95% confidence interval [0.81, 0.94], P < .0001). The total amount of insulin in the pen, the ease in pressing the injection button, and the amount of fluid injected were key attributes influencing IL 200 pen preference. Conclusions: Based on these key attributes, the IL 200 pen was significantly preferred over the IL 100 pen by patients with diabetes who require >20 daily mealtime insulin units or diabetes caregivers and may improve the injection experience for these patients.

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Reduced Risk of Hypoglycemia with Insulin Degludec Versus Insulin Glargine in Patients with Type 2 Diabetes Requiring High Doses of Basal Insulin: A Meta-Analysis of 5 Randomized Begin Trials

Cited by 52 publications

References 14 publications

Efficacy and safety of insulin degludec U100 and insulin glargine U100 in combination with meal-time bolus insulin in hospitalized patients with type 2 diabetes: an open-label, randomized controlled study

Efficacy and safety of insulin degludec U100 and insulin glargine U100 in combination with meal-time bolus insulin in hospitalized patients with type 2 diabetes: an open-label, randomized controlled study

Degludec is effective and safe in real-life treatment for patients with type 2 diabetes mellitus and chronic kidney disease stage 3B

Attributes Influencing Insulin Pen Preference Among Caregivers and Patients With Diabetes Who Require Greater Than 20 Units of Mealtime Insulin

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