Insulin degludec vs. insulin glargine: which one gives more consistent blood glucose levels?

This study examined the variability of insulin degludec and insulin glargine in reducing blood glucose levels.

Patients with type1 diabetes (T1D) must inject rapid-acting insulin and long-acting insulin each day. Insulin glargine (Lantus) is a long-acting insulin injected once daily. It slowly reduces blood glucose levels over 24 hours. Insulin degludec (Tresiba) is an ultra-long acting insulin which lasts for up to 40 hours.

The fasting plasma glucose (sugar) test is used to measure blood glucose levels in an individual who has not eaten anything for 8 hours. Long-acting insulin maintains blood glucose levels at a steady level in the absence of food or rapid-acting insulin. It is believed that insulin degludec is associated with similar blood glucose levels, a lower daily insulin dose and fewer incidences of low blood glucose levels at night.

This study aimed to compare the fasting plasma glucose levels in patients receiving insulin degludec to patients receiving insulin glargine.

This study involved 36 T1D patients divided into 2 groups. All participants recieved each type of insulin for 4 weeks. 17 participants received insulin degludec first followed by insulin glargine, while 19 participants received insulin glargine followed by insulin degludec. Participants received the insulin once daily for 4 weeks.

Insulin degludec led to lower average fasting plasma glucose levels (7.74 mmol/L) in comparison to insulin glargine (8.56 mmol/L). Variation in blood glucose levels was lower with insulin degludec (2.60 +/- 0.97 mmol/L) compared to insulin glargine (3.19 +/- 1.36 mmol/L). A lower dose of insulin degludec (11 U per day) was required compared to insulin glargine (11.8 U per day).

This study concluded that insulin degludec lowers average blood glucose levels and also reduces variation in blood glucose levels compared to insulin glargine. 

The sample size of 36 participants was small. In addition, the effects of insulin degludec should ideally be measured over a longer time period. 

Consult your physician regarding the availability and benefits of insulin degludec.