Favorable Glycemic Control with Once-Daily Insulin Degludec/Insulin Aspart after Changing from Basal Insulin in Adults with Type 2 Diabetes
10.3803/EnM.2019.34.4.382
- Author:
Han Na JANG
1
;
Ye Seul YANG
;
Seong Ok LEE
;
Tae Jung OH
;
Bo Kyung KOO
;
Hye Seung JUNG
Author Information
1. Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. junghs@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Insulin degludec, insulin aspart drug combination;
Diabetes mellitus, type 2;
Insulin deficiency;
Hyperglycemia;
Basal insulin
- MeSH:
Adult;
Blood Glucose;
C-Peptide;
Diabetes Mellitus, Type 2;
Fasting;
Humans;
Hyperglycemia;
Insulin;
Male;
Referral and Consultation;
Retrospective Studies
- From:Endocrinology and Metabolism
2019;34(4):382-389
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Conflicting results have been reported on the efficacy of insulin degludec/insulin aspart (IDegAsp) compared to basal insulin in type 2 diabetes. We investigated the effects of changing basal insulin to IDegAsp on glycemic control and sought to identify factors related to those effects.METHODS: In this retrospective study of patients from three referral hospitals, patients with type 2 diabetes using basal insulin with hemoglobin A1c (HbA1c) levels less than 11.0% were enrolled. Basal insulin was replaced with IDegAsp, and data were analyzed from 3 months before to 3 months after the replacement.RESULTS: Eighty patients were recruited (52.5% male; mean age, 67.0±9.8 years; mean duration of diabetes, 18.9±8.5 years; mean HbA1c, 8.7%±1.0%). HbA1c levels increased during 3 months of basal insulin use, but significantly decreased after changing to IDegAsp (8.28%±1.10%, P=0.0001). The reduction was significant at 6 months in 35 patients whose longer-term data were available. Patients with a measured fasting plasma glucose (m-FPG) lower than their predicted FPG (p-FPG) by regression from HbA1c showed a significant HbA1c reduction caused by the change to IDegAsp, even without a significantly increased insulin dose. However, patients whose m-FPG was higher than their p-FPG did not experience a significant HbA1c reduction, despite a significantly increased insulin dose. Furthermore, the HbA1c reduction caused by IDegAsp was significant in patients with low fasting C-peptide levels and high insulin doses.CONCLUSION: We observed a significant glucose-lowering effect by replacing basal insulin with IDegAsp, especially in patients with a lower m-FPG than p-FPG.
