Effects of Switching from Degludec to Glargine U300 in Patients with Insulin-Dependent Type 1 Diabetes: A Retrospective Study-Reference-Cited by-同舟云学术

Effects of Switching from Degludec to Glargine U300 in Patients with Insulin-Dependent Type 1 Diabetes: A Retrospective Study

Published:2024-03-08 Issue:3 Volume:60 Page:450
ISSN:1648-9144
Container-title:Medicina
language:en
Short-container-title:Medicina

Author:

Sawamura Toshitaka¹²³⁴^ORCID,Karashima Shigehiro⁴^ORCID,Ohbatake Azusa²⁴,Higashitani Takuya²³⁴,Ohmori Ai¹²,Sawada Kei¹⁴,Yamamoto Rika¹⁴,Kometani Mitsuhiro¹²⁴^ORCID,Katsuda Yuko²³,Yoneda Takashi²³⁴

Affiliation:

1. Department of Internal Medicine, Asanogawa General Hospital, 83 Kosakamachi, Kanazawa 910-8621, Japan

2. Department of Endocrinology and Metabolism, Kanazawa University Graduate School of Medicine, 13-1 Takaramachi, Kanazawa 920-8641, Japan

3. Department of Diabetes and Endocrinology and Internal Medicine, Fukui Prefectural Hospital, 2-8-1 Yotsui, Fukui 910-8526, Japan

4. Department of Health Promotion and Medicine of the Future, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8641, Japan

Abstract

Background and Objectives: Degludec (Deg) and glargine U300 (Gla-300) are insulin analogs with longer and smoother pharmacodynamic action than glargine U100 (Gla-100), a long-acting insulin that has been widely used for many years in type 1 and type 2 diabetes. Both improve glycemic variability (GV) and the frequency of hypoglycemia, unlike Gla-100. However, it is unclear which insulin analog affects GV and hypoglycemia better in patients with insulin-dependent type 1 diabetes. We evaluated the effects of switching from Deg to Gla-300 on the day-to-day GV and the frequency of hypoglycemia in patients with insulin-dependent type 1 diabetes treated with Deg-containing basal-bolus insulin therapy (BBT). Materials and Methods: We conducted a retrospective study on 24 patients with insulin-dependent type 1 diabetes whose treatment was switched from Deg-containing BBT to Gla-300-containing BBT. We evaluated the day-to-day GV measured as the standard deviation of fasting blood glucose levels (SD-FBG) calculated by the self-monitoring of blood glucose records, the frequency of hypoglycemia (total, severe, and nocturnal), and blood glucose levels measured as fasting plasma glucose (FPG) levels and hemoglobin A1c (HbA1c). Results: The characteristics of the patients included in the analysis with high SD-FBG had frequent hypoglycemic events, despite the use of Deg-containing BBT. For this population, SD-FBG and the frequency of nocturnal hypoglycemia decreased after the switch from Deg to Gla-300. Despite the decrease in the frequency of nocturnal hypoglycemia, the FPG and HbA1c did not worsen by the switch. The change in the SD-FBG had a negative correlation with the SD-FBG at baseline and a positive correlation with serum albumin levels. Conclusions: Switching from Deg to Gla-300 improved the SD-FBG and decreased the frequency of nocturnal hypoglycemia in insulin-dependent type 1 diabetes treated with Deg-containing BBT, especially in cases with low serum albumin levels and a high GV.

Publisher

MDPI AG

Link

https://www.mdpi.com/1648-9144/60/3/450/pdf

Reference38 articles.

1. Diabetes Control and Complications Trial (DCCT) Research Group (1996). The absence of a glycemic threshold for the development of long-term complications: The perspective of the Diabetes Control and Complications Trial. Diabetes, 45, 1289–1298.

2. Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes;Nathan;N. Engl. J. Med.,2005

3. Prevention of cardiovascular disease in persons with type 2 diabetes mellitus: Current knowledge and rationale for the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial;Goff;Am. J. Cardiol.,2007

4. Bonds, D.E., Miller, M.E., Bergenstal, R.M., Buse, J.B., Byington, R.P., Cutler, J.A., Dudl, R.J., Ismail-Beigi, F., Kimel, A.R., and Hoogwerf, B. (2010). The association between symptomatic, severe hypoglycemia and mortality in type 2 diabetes: Retrospective epidemiological analysis of the ACCORD study. BMJ, 340.

5. Goto, A., Arsh, O.A., Goto, M., Terauchi, Y., and Noda, M. (2013). Severe hypoglycemia and cardiovascular disease: Systematic review and meta-analysis with bias analysis. BMJ, 347.