Significant A1c Reduction Vs Insulin Glargine U-1001
WARNING: RISK OF THYROID C-CELL TUMORS Liraglutide, one of the components of Xultophy® 100/3.6, causes dose-dependent and treatment-duration-dependent thyroid C-cell tumors at clinically relevant exposures in both genders of rats and mice. It is unknown whether Xultophy® 100/3.6 causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans, as the human relevance of liraglutide-induced rodent thyroid C-cell tumors has not been determined. Xultophy® 100/3.6 is contraindicated in patients with a personal or family history of MTC and in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Counsel patients regarding the potential risk for MTC with the use of Xultophy® 100/3.6 and inform them of symptoms of thyroid tumors (e.g. a mass in the neck, dysphagia, dyspnea, persistent hoarseness). Routine monitoring of serum calcitonin or using thyroid ultrasound is of uncertain value for early detection of MTC in patients treated with Xultophy® 100/3.6. Xultophy® 100/3.6 (insulin degludec and liraglutide injection) 100 units/mL and 3.6 mg/mL is a combination of insulin degludec and liraglutide and is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus inadequately controlled on basal insulin (less than 50 units daily) or liraglutide (less than or equal to 1.8 mg daily). Xultophy® 100/3.6 is not recommended as first-line therapy for patients who have inadequate glycemic control on diet and exercise. Xultophy® 100/3.6 has not been studied in patients with a history of pancreatitis. Consider other antidiabetic therapies in patients with a history of pancreatitis. Xultophy® 100/3.6 is not recommended for use in combination with any other product containing liraglutide or another Continue reading >>
Insulin Degludec | Switch Studies Support Reduced Hypoglycemia Risk With Insulin Degludec | Diabetes.medicinematters.com
SWITCH studies support reduced hypoglycemia risk with insulin degludec medwireNews: Head-to-head trials of the ultralong-acting insulin degludec versus insulin glargine U100 show that the former significantly reduces the risk for hypoglycemia in patients with type 1 and type 2 diabetes. The SWITCH studies, both published in JAMA, assigned patients to receive each study medication for a 16-week titration period followed by a 16-week maintenance period, in a randomized order. In SWITCH 1 , which included 501 patients with type 1 diabetes, hypoglycemia occurred at rates of 2200.9 versus 2462.7 episodes per 100 personyears of exposure during the degludec and glargine periods, respectively, equating to a significant 11% reduction with degludec. Degludec treatment was also associated with a significant reduction in nocturnal hypoglycemia, at 277.1 versus 428.6 episodes per 100 personyears of exposure, and a significantly lower proportion of patients with severe hypoglycemic episodes during the maintenance period, at 10.3% versus 17.1%. In both trials, hypoglycemia was defined as blood glucose less than 56mg/dL and/or requiring the assistance of another person to take corrective measures; the latter was also the definition of severe hypoglycemia. Editorialists Elizabeth Seaquist and Lisa Chow, both from the University of Minnesota in Minneapolis, USA, note that the overall hypoglycemia definition will make it hard to compare the SWITCH trials with future research, given that current guidelines also count asymptomatic episodes with blood glucose below 54mg/dL. The rationale is that glucose levels less than 54mg/dL are associated with impaired cognitive function and predict cardiac arrhythmias and mortality, they say, as well as being an indicator of impaired hypoglycemia aware Continue reading >>
New Insulins Present Benefits, Challenges
The deluge of diabetes shows no signs of stopping. The disease now affects 29.1 million people in the U.S., including 8 million or so who remain undiagnosed, according to CDC statistics published in 2014. Add to this the latest CDC estimate that 86 million patients have prediabetes, and the number of diabetes cases will conceivably multiply in coming years. “Unless we are able to get everybody exercising, following all components of the [Diabetes Prevention Program], and also eating well, these individuals will likely go on to develop actual type 2 diabetes at some point. We may be talking about 30 million now, but we're looking at 90 million later,” said Lillian Lien, MD, ACP Member, division chief of endocrinology, metabolism, and diabetes and a professor of medicine at the University of Mississippi Medical Center in Jackson. During her session at the “Diabetes for the Internist” pre-course at Internal Medicine Meeting 2016, Dr. Lien explained how types of insulin newly approved by the FDA present new opportunities and challenges for glycemic control. (Dr. Lien disclosed that she is a consultant for insulin manufacturers Sanofi-Aventis, Merck, Eli Lilly, and Novo Nordisk.) Insulin human injection U-500 The concentration of subcutaneous insulins is an increasingly important issue that matters more than it used to, Dr. Lien said. In the past, the only insulin syringes on the market were U-100, so clinicians often had to draw up U-500 (super-concentrated) insulin in tuberculin syringes or try to perform dose conversions, she said. “We hope this will be overcome by the recent introduction of the Humulin R U-500 KwikPen, which is live this year,” she said, although she noted that it is sometimes difficult for patients to afford. The FDA approved the U-500 short Continue reading >>
Tresiba Dosage
Important Administration Instructions • • Inspect visually for particulate matter and discoloration. Only use TRESIBA if the solution appears clear and colorless. • Train patients on proper use and injection technique before initiating TRESIBA. Training reduces the risk of administration errors such as needle sticks and incomplete dosing. • Inject TRESIBA subcutaneously into the thigh, upper arm, or abdomen. • Rotate injection sites within the same region from one injection to the next to reduce the risk of lipodystrophy [see Adverse Reactions (6.1)]. • DO NOT administer TRESIBA intravenously, intramuscularly or in an insulin infusion pump. • DO NOT dilute or mix TRESIBA with any other insulin products or solutions. • DO NOT transfer TRESIBA from the TRESIBA pen into a syringe for administration [see Warnings and Precautions (5.4)]. General Dosing Instructions • In adults, inject TRESIBA subcutaneously once-daily at any time of day. • In pediatric patients inject TRESIBA subcutaneously once-daily at the same time every day. • Individualize and titrate the dose of TRESIBA based on the patient’s metabolic needs, blood glucose monitoring results, and glycemic control goal. • The recommended days between dose increases is 3 to 4 days. • Dose adjustments may be needed with changes in physical activity, changes in meal patterns (i.e., macronutrient content or timing of food intake), changes in renal or hepatic function or during acute illness to minimize the risk of hypoglycemia or hyperglycemia [see Warnings and Precautions (5.3)]. • For adult patients, instruct patients who miss a dose of TRESIBA to inject their daily dose during waking hours upon discovering the missed dose. Instruct patients to ensure that at least 8 hours have elapsed betwee Continue reading >>
New High Strength Insulins
Home » IDDT News » New High Strength Insulins Several new insulins have come to the market recently; three high strength insulins which have concentrations greater than the previously standard strength of U100 and biosimilar insulin. The Trustees of IDDT have discussed the introduction of different strengths of insulin in depth and strongly expressed their concerns about the risks of errors by people with diabetes, health professionals and hospitals. These concerns come from their experiences of the introduction of the first genetically modified human insulin in the 1980s when there was a dearth of evidence of benefit and many people with diabetes were not informed of the differences from their previous natural animal insulin. These new stronger insulins have been largely developed for people who require large doses of insulin to reduce the volume injected and the number of injections. Here are the details of the new insulins: Key feature Active substance Brand name Strengths Injection device High strength Insulin degludec Tresiba U100: U200 FlexTouch prefilled pen Insulin lispro Humalog U100: U200 KwikPen prefilled pen Insulin glargine Lantus Toujeo U100 U300 SoloSTAR prefilled pen Fixed combination Insulin degludec and liraglutide Xultophy Degludec and 3.6mg/mL of liraglutide (Victoza) U100 cartridge Prefilled pen Biosimilar Insulin glargine Abasaglar U100 Lilly reusable pen KwikPen prefilled pen The European Medicines Agency is consulting on safety advice and the MHRA in the UK has stated that it is important that patients and health professionals are aware of the different strengths and how to use them to minimise the risk of medication errors, such as the wrong dose of insulin being injected. New term – the ‘dose step’ The ‘dose step’ is a new term to d Continue reading >>
U €¦â€¦ What Hundred???
CME Disclosures I have no disclosures relevant to today’s presentation Objectives Demonstrate understanding of dose conversion for each concentrated insulin Distinguish the ideal patient population for each concentrated insulin Evaluate safety concerns of concentrated insulins Summarize cost saving options for concentrated insulins Diabetes and Obesity Epidemics 29.1 million Americans have diabetes1 90% of patients with type 2 diabetes are overweight or obese2 Progressively higher doses of insulin over course of care3 National Health Survey, 2010-2012, adults >18 yo4 14% on insulin only 14.7% on insulin and oral medications 1. www.diabetes.org/diabetes-basics/statistics/ 2. www.who.int/dietphysicalactivity/media/en/gsfs_obesity.pdf 3. Watson et al. Diabetes, Obesity, and Metabolism. 2011; 13: 823-831 4. www.cdc.gov/diabetes/pubs/statsreport14/ Ref for 29.1 million: -ïƒ NOTES: only 1.25 million are Type 1 SAY and as you know it has been projected that by 2050, 1 in 3 americans will have diabetes ïƒ its estimated that 95% are Type 2 Ref for 85.2% are obese ïƒ CDC Morbidity and Mortality Weekly Report MMWR 2003; above fact sheet Ref for health Survey: (of NOTE: with diagnosed diabetes) 4 Obesity and Insulin Resistance Lamos E. Therapeutics and Clinical Risk Management. 2016; 12: 389-400 Insulin Resistance Insulin Secretion Insulin doses Ref: Concentrated Insulins article by E. Lamos in Therapeutics and Clinical Risk Management. 2016 NOTES: In someone in which type 2 diabetes mellitus is diagnosed, insulin resistance is usually accompanied by a defect in insulin secretion. Initially, someone who is insulin resistant can compensate for decreased insulin responsiveness by secreting more insulin. In fact, another way to reveal insulin resistance is to look at the Continue reading >>
Clinical Use Of Insulin Degludec - Sciencedirect
Volume 109, Issue 1 , July 2015, Pages 19-31 Author links open overlay panel JitenVoraa Insulin degludec (IDeg) is a novel basal insulin with improved PK and PD properties. IDeg improves glycaemic control and significantly reduces the risk of hypoglycaemia. When switching to IDeg, this can be done unit-to-unit or may require dose reduction. Dose adjustment with IDeg can be carried out once-weekly in steps of 2units. The ultra-long duration of action of IDeg allows for dose flexibility, if needed. The limitations of current basal insulin preparations include concerns related to their pharmacokinetic and pharmacodynamic properties, hypoglycaemia, weight gain, and perception of management complexity, including rigid dosing schedules. Insulin degludec (IDeg) is a novel basal insulin with improved pharmacokinetic and pharmacodynamic properties compared to insulin glargine (IGlar) including a long half-life of 25h and a duration of action >42h at steady state, providing a flat and stable blood glucose-lowering effect when injected once daily. Evidence from phase 3a clinical trials with a treat-to-target design in patients with type 1 and type 2 diabetes has shown that IDeg has similar efficacy to IGlar, with a 9% and 26% reduction in risk of overall and nocturnal hypoglycaemia, respectively (in the pooled population) during the entire treatment period, and a 16% and 32% reduction during the maintenance period, respectively. Given its pharmacodynamic properties, IDeg offers a broad dosing window, allowing for flexible dose administration, if required. Two different formulations of IDeg are available (100units/mL [U100] and 200units/mL), the latter providing the same IDeg dose as the U100 formulation in half the injection volume. The unique pharmacokinetic profile of IDeg faci Continue reading >>
How Tresiba® Works
Read the Instructions for Use and take Tresiba® exactly as your health care provider tells you to Do not do any conversion of your dose. The dose counter always shows the selected dose in units Know the type and strength of insulin you take. Do not change the type of insulin you take unless your health care provider tells you to Adults - If you miss or are delayed in taking your dose of Tresiba®: Take your dose as soon as you remember, then continue with your regular dosing schedule Make sure there are at least 8 hours between doses If children miss a dose of Tresiba®: Call the healthcare provider for information and instructions about checking blood sugar levels more often until the next scheduled dose of Tresiba® Check your blood sugar levels. Ask your health care provider what your blood sugar levels should be and when you should check them Do not reuse or share your needles with other people. You may give them a serious infection, or get a serious infection from them Never inject Tresiba® into a vein or muscle Never use a syringe to remove Tresiba® from the FlexTouch® pen Tresiba® may cause serious side effects that can be life-threatening, including: Low blood sugar (hypoglycemia). Signs and symptoms that may indicate low blood sugar include anxiety, irritability, mood changes, dizziness, sweating, confusion, and headache Low potassium in your blood (hypokalemia) Heart failure in some people if taken with thiazolidinediones (TZDs). This can happen even if you have never had heart failure or heart problems. If you already have heart failure, it may get worse while you take TZDs with Tresiba®. Tell your health care provider if you have any new or worse symptoms of heart failure including shortness of breath, tiredness, swelling of your ankles or feet, and su Continue reading >>
Effects Of Switching From Insulin Glargine Or Detemir To Insulin Degludec In Patients With Type 1 Diabetes Mellitus
Insulin degludec is a new, ultra-long-acting basal insulin. The aim of this study was to analyze the changes of basal insulin dose and blood glucose profile in basal-bolus therapy of type 1 diabetes mellitus (T1DM) at the switching of basal insulin from insulin glargine or detemir to insulin degludec.Sixteen patients with T1DM were enrolled. The patients underwent continuous glucose monitoring before and after the switching of insulin glargine or detemir to degludec. Ten patients treated with insulin glargine or detemir twice daily, were switched to insulin degludec with 80-90% of the prior insulin dose. The remaining six patients treated with insulin glargine once daily, were switched to insulin degludec without down titration. The changes of daily insulin dose and glycated hemoglobin (HbA1c) were also examined for 12 weeks after switching to insulin degludec.In the patients switched from twice-daily basal insulin, no significant difference was found between before and after switching in the blood glucose profile. In the once-daily group, blood glucose levels showed a tendency to decrease after switching to the degludec treatment. During the study period, total daily insulin dose (TDD) and total daily basal insulin dose (TBD) decreased significantly in the twice-daily group, and TDD and TBD showed a tendency to decrease after switching to degludec in the once-daily group. In both groups, the changes of HbA1c were not significantly different.It is possible to achieve similar glycemic control with once-daily injection and lower doses of insulin degludec in patients with T1DM who have been treated with insulin glargine or detemir. Do you want to read the rest of this article? ... In type 2 diabetes, HbA 1C improved, and the number of basal injections per day became lower Continue reading >>
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Tresiba Safer Than Insulin Glargine, Says Novo Nordisk
Diabetics treated with Novo Nordisk's basal insulin Tresiba have a lower risk of developing low blood sugar compared to Sanofi's Lantus, according to a new trial. The SWITCH 2 study found that type 2 diabetics taking Tresiba (insulin degludec) were less likely to have symptoms of low blood sugar (hypoglycaemia) compared to those taking Lantus (insulin glargine), the most-prescribed basal insulin product. Tresiba was as good as Lantus at reducing haemoglobin A1c levels - a marker for glucose control. However, the rate of symptomatic hypoglycaemia was 186 events per 100 patient years for Novo Nordisk's drug, a 30% reduction on the 265 events per 100 patient years seen with insulin glargine. Similarly, nocturnal low blood sugar episodes were reduced 42% with Tresiba compared to Lantus, although there was no significant difference between the two drugs in the rate of severe hypoglycaemic episodes. Hypoglycaemia is one of the biggest concerns for diabetics and, taken together, the results could give Novo Nordisk additional power as it tries to wrest market share away from $7bn-a-year Lantus. Moreover, it could also differentiate Tresiba from biosimilar copies of Sanofi's drug that are starting to reach the market and threaten to disrupt the basal insulin category. Novo Nordisk had been held back in its efforts to compete with Lantus by a delay to US approval of Tresiba, with the FDA rejecting its marketing application for the drug in 2013, although it has been launched in most other major markets. Last October however the Danish drugmaker finally won US approval for Tresiba and combination product Ryzodeg (insulin degludec and insulin aspart), prompting analysts at Sydbank to increase their peak sales predictions for the franchise to around $3bn. In some markets the drug has Continue reading >>
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Insulin Degludec Versus Insulin Glargine In Insulin-naive Patients With Type 2 Diabetes
OBJECTIVE To compare ultra-long-acting insulin degludec with glargine for efficacy and safety in insulin-naive patients with type 2 diabetes inadequately controlled with oral antidiabetic drugs (OADs). RESEARCH DESIGN AND METHODS In this 1-year, parallel-group, randomized, open-label, treat-to-target trial, adults with type 2 diabetes with A1C of 7−10% taking OADs were randomized 3:1 to receive once daily degludec or glargine, both with metformin. Insulin was titrated to achieve prebreakfast plasma glucose (PG) of 3.9−4.9 mmol/L. The primary end point was confirmation of noninferiority of degludec to glargine in A1C reduction after 52 weeks in an intent-to-treat analysis. RESULTS In all, 1,030 participants (mean age 59 years; baseline A1C 8.2%) were randomized (degludec 773, glargine 257). Reduction in A1C with degludec was similar (noninferior) to that with glargine (1.06 vs. 1.19%), with an estimated treatment difference of degludec to glargine of 0.09% (95% CI −0.04 to 0.22). Overall rates of confirmed hypoglycemia (PG <3.1 mmol/L or severe episodes requiring assistance) were similar, with degludec and glargine at 1.52 versus 1.85 episodes/patient-year of exposure (PYE). There were few episodes of nocturnal confirmed hypoglycemia in the overall population, and these occurred at a lower rate with degludec versus glargine (0.25 vs. 0.39 episodes/PYE; P = 0.038). Similar percentages of patients in both groups achieved A1C levels <7% without hypoglycemia. End-of-trial mean daily insulin doses were 0.59 and 0.60 units/kg for degludec and glargine, respectively. Adverse event rates were similar. CONCLUSIONS Insulins degludec and glargine administered once daily in combination with OADs provided similar long-term glycemic control in insulin-naive patients with type 2 Continue reading >>
Advances In Insulin Therapy: A Review Of Insulin Degludec
Introduction Basal insulin has been an important treatment option for patients with diabetes mellitus (DM) and, along with prandial insulin, has undergone major improvements in terms of purity and similarity to the action of physiologic human insulin. (see The Evolution of Insulin Therapy in Diabetes Mellitus in this supplement.) Lente and Ultralente formulations were used for decades but are no longer available. The use of neutral protamine Hagedorn (NPH) insulin is also being replaced with the basal insulin analogs detemir and glargine.1 Basal insulin analogs generally cause less severe and nocturnal hypoglycemia compared with NPH insulin owing to their improved pharmacologic profiles.2-4 In comparison to NPH insulin, insulin glargine causes similar weight gain, whereas insulin detemir causes less weight gain.2-4 In addition, insulin detemir has been associated with a glucose-lowering effect that is more predictable than that of NPH insulin.5 Despite the improvements observed with basal insulin analogs, their time-action profiles are not completely flat and are shorter than 24 hours in many patients.5,6 In addition, severe hypoglycemia remains a concern, particularly in patients with type 1 DM (T1DM).7,8 Consequently, the search for a better basal insulin continues. The ideal basal insulin should possess numerous attributes. While each of the attributes listed in the TABLE is important, an overarching difficulty with basal insulin therapy is the need for administration at the same time each day.9 This dosing limitation may be most difficult for those with busy or erratic schedules or who may forget to administer their insulin dose. This article will review the clinical experience with insulin degludec, an ultra–long-acting insulin under review by the US Food and Dru Continue reading >>
Efficacy Of Switching From Insulin Glargine To Insulin Degludec In Patients With Type 1 Diabetes: A 16-week Retrospective Study
Efficacy of switching from insulin glargine to insulin degludec in patients with type 1 diabetes: a 16-week retrospective study We retrospectively investigated the effect of switching from insulin glargine (IGlar) to insulin degludec (IDeg) on glycemic control in Japanese patients with type 1 diabetes mellitus. We also evaluated the dose of IDeg, and assessed weight gain and the risk of hypoglycemia after switching. Forty-five patients with type 1 diabetes were switched from IGlar (once daily or twice daily) to IDeg (once daily) during routine medical care. Data were collected for 16weeks after switching from IGlar to IDeg. The mean HbA1c (%) in weeks 4, 8, 12, and 16 was lower than it was in week 0 (8.01.0, 8.01.4, 7.91.1, 7.61.0 vs. 8.31.3%, p<0.01). The total basal insulin dose (TBD) was significantly lower after 16weeks of IDeg as compared to IGlar treatment (0.300.12 vs. 0.240.11U/kg/day, p=0.001). In the twice-daily IGlar group, TBD showed a significant decrease from 0.330.12 to 0.260.11U/kg/day (p<0.001) after switching to IDeg. In the once-daily IGlar group, TBD showed a slight but not significant decrease from 0.230.08 to 0.200.09U/kg/day (p=0.97). Hypoglycemic episodes were transiently increased, but the change was not significant. The blood glucose fluctuation was evaluated from self-monitoring data and the coefficient of variation (CV) was calculated. The CV showed only a minimal change from 48.317.1 to 48.614.2% at 12weeks after switching to IDeg (p=0.73). In conclusion, once-daily IDeg improved glycemic control in patients with type 1 diabetes compared to the control achieved with IGlar, without increasing the risk of hypoglycemia. When switching from IGlar (especially twice daily), it is recommended that the initial dose of IDeg should be reduced in orde Continue reading >>
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- Study: New oral drug helps control glucose, reduces need for insulin in patients with type 1 diabetes
Study Shows Switching To Toujeo Lowers Risk Of Hypoglycemia In Seniors With Diabetes
Patients who switched to insulin glargine were 57% less likely to experience hypoglycemia. The results of the DELIVER 3 retrospective observational study have been presented at the American Diabetes Association (ADA)’s 77th Scientific Sessions in San Diego, California. In making the presentation, Sanofi announced its new evidence demonstrating a significantly lower risk of hypoglycemia with similar blood sugar control in an at-risk population of senior adult patients (aged ≥65 years) with type 2 diabetes (T2D) after switching to Toujeo (insulin glargine 300 Units/mL) compared with switching to another basal insulin, including Lantus/Sanofi (insulin glargine 100 Units/mL), Levemir/Novo Nordisk (insulin detemir) and Tresiba/Novo Nordisk (insulin degludec). Hypoglycemia was identified in the dataset by International Classification of Diseases (ICD)-9 and ICD-10 diagnosis codes or by plasma glucose, measured as ≤ 70 mg/dL by laboratory test. A long-acting insulin used to control blood sugar in adult patients with diabetes, insulin glargine 300 Units/mL contains 3 times as much insulin in 1 mL as standard insulin 100 Units/mL. It should not be used to treat diabetic ketoacidosis, and should not be used in children with diabetes. "Older patients with type 2 diabetes are disproportionately impacted by hypoglycemia and its consequences," Jeremy Pettus, an assistant professor in the Division of Endocrinology at the University of California San Diego, said in a company news release announcing the results. "Observational real-world data such as DELIVER 3 can contribute to clinical decision-making, helping physicians to better advise their patients in this important at-risk population." The study found that the patients who switched to insulin glargine 300 Units/mL were 57% l Continue reading >>
Lower Rates Of Hypoglycemia In Patients Treated With Insulin Degludec
Lower rates of hypoglycemia in patients treated with insulin degludec 1. Treatment with insulin degludec resulted in a lower rate of overall symptomatic hypoglycemic episodes compared with insulin glargine U100. 2. Rates of nocturnal symptomatic hypoglycemia were also lower with insulin degludec compared with insulin glargine U100. Study Rundown: Hypoglycemia is a problem with many insulin-treated patients with type 2 diabetes (T2D). The frequency and severity tends to increase with disease progression, and it is one of the most concerning complications associated with insulin therapy. Insulin analogs U100 and glargine at similar hemoglobin levels have been shown to reduce the frequency of overall and nocturnal hypoglycemia, owing to their longer half-lives resulting in lower day-to-day variability. A meta-analysis of open-label trials from the insulin degludec phase 3a program interestingly showed that overall and nocturnal hypoglycemia were lower compared with insulin glargine U100. The SWITCH 2 trial, as presented in this study, was designed as a randomized, double-blind, 2-period crossover study to evaluate the hypoglycemia benefit from insulin degludec compared with insulin glargine U100. A total 721 patients were randomized, with 580 (80.4%) completing the trial. Rates of overall hypoglycemia were significantly lower with insulin degludec vs insulin glargine U100 (rate ratio 0.70, 95%CI 0.61-0.80, p < 0.001). Similarly, rates of nocturnal symptomatic hypoglycemia were also lower with insulin degludec vs insulin glargine U100 (rate ratio 0.58, 95%CI 0.46-0.74; p < 0.001). Overall, the results of this study suggest that patients with T2D treated with insulin degludec have an overall lower risk of hypoglycemia. Limitations of this study include exclusion of patients Continue reading >>
