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Switching to Degludec from Other Basal Insulins is Associated with Reduced Hypoglycemia Rates : a Prospective Study

Fadini, Gian Paolo (författare)
Department of Medicine, Division of Metabolic Diseases, University of Padova, Padova, Italy
Feher, Michael (författare)
Beta Cell Diabetes Centre, Chelsea and Westminster Hospital, London, UK; Department of Clinical and Experimental Medicine, University of Surrey, Guilford, UK
Hansen, Troels Krarup (författare)
Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
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de Valk, Harold W. (författare)
Department of Internal Medicine, University Medical Center Utrecht, Utrecht, the Netherlands
Koefoed, Mette Marie (författare)
Novo Nordisk A/S, Søborg, Denmark
Wolden, Michael (författare)
Novo Nordisk A/S, Søborg, Denmark
Zimmerman, E. (författare)
Novo Nordisk A/S, Søborg, Denmark
Jendle, Johan, 1963- (författare)
Örebro universitet,Institutionen för medicinska vetenskaper
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 (creator_code:org_t)
2019-08-09
2019
Engelska.
Ingår i: Journal of Clinical Endocrinology and Metabolism. - : Oxford University Press. - 0021-972X .- 1945-7197. ; 104:12, s. 5977-5990
Relaterad länk:
https://doi.org/10.1...
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https://academic.oup...
https://urn.kb.se/re...
https://doi.org/10.1...
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  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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  • CONTEXT: Observational studies of insulin degludec (degludec) with hypoglycemia events prospectively recorded are lacking.OBJECTIVE: To evaluate the safety and effectiveness of degludec in patients with type 1 (T1D) or type 2 diabetes (T2D) switching from other basal insulins in routine care.DESIGN: ReFLeCT was a multinational, multicenter, prospective, observational, single-arm study comprising a 4-week baseline period (pre-switch basal insulin) and 12-month follow-up (degludec).SETTING: Routine clinical practice. Patients or Other Participants: Insulin-treated patients (≥18 years) with T1D (n=556) or T2D (n=611) with treatment plans to initiate degludec.INTERVENTIONS: Switching to degludec from other basal insulins.MAIN OUTCOME MEASURE(S): Change from baseline in number of overall hypoglycemic events recorded in patient diaries.RESULTS: In T1D, the 12-month follow-up/baseline rate ratios [95% CI] of overall (0.80 [0.74;0.88]), non-severe (0.83 [0.76;0.91]), severe (0.28 [0.14;0.56]) and nocturnal (0.61 [0.50;0.73]) hypoglycemia suggested significantly reduced hypoglycemia rates with degludec (all P<0.001). At 12 months, HbA1c, fasting plasma glucose (FPG) and basal insulin dose decreased significantly. Body weight increased and treatment satisfaction improved significantly. In T2D, the hypoglycemia rate ratios were: overall (0.46 [0.38;0.56]), non-severe (0.53 [0.44;0.64]) and nocturnal (0.35 [0.20;0.62]) (all P<0.001; too few events for analysis of severe). At 12 months, HbA1c and FPG decreased significantly. Body weight and insulin doses remained unchanged, and treatment satisfaction was significantly improved.CONCLUSIONS: In a routine clinical care setting, switching to degludec from other basal insulins was associated with significantly reduced rates of hypoglycemia, improved glycemic control, and treatment satisfaction in patients with T1D or T2D.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)

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