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Posted by on Aug 26, 2017 in Diabetes mellitus | 0 comments

In a nutshell

This study investigated if insulin degludec was as effective as insulin glargine U100 in reducing rates of hypoglycemia (low blood sugar) in patients with type 1 diabetes.

They found that patients receiving insulin degludec had a reduced risk of hypoglycemia compared to those receiving insulin glargine U100.

Some background

Managing blood sugar levels is key in treating type 1 diabetes (T1D) to prevent the development of long-term complications. Patients with T1D do not produce the hormone insulin, which is needed to regulate blood sugar levels. These patients must replace insulin by injection or insulin pump. Insulin treatment, however, can increase the risk of hypoglycemia (dangerously low blood sugar levels).

Insulin degludec and insulin glargine U100 are two insulin replacements. Insulin degludec is longer lasting than insulin glargine U100. It is not clear whether insulin degludec was associated with lower rates of hypoglycemia.

Methods & findings

 This study investigated if it was equal or superior in reducing the number of hypoglycemic episodes. 

501 patients were included in this study. 395 completed the full trial. Patients were assigned to receive either insulin degludec or insulin glargine U100 for the first 32-week period. Patients then switched to the opposite medication for the second period. The number of hypoglycemic episodes (blood glucose less than 56 mg/dL) were recorded.

The rate of hypoglycemia was lower in patients receiving insulin degludec (11% less compared to insulin glargine U100). Nocturnal (night-time) hypoglycemia was also lower following treatment with insulin degludec (36% less compared to insulin glargine U100). HbA1c levels (average blood glucose over 3 months) were not statistically different between the groups. The rate of negative events were similar between both groups.

The bottom line

This study concluded that insulin degludec more efficient at reducing hypoglycemic episodes in patients with type 1 diabetes. 

The fine print

The patients in this study were predominantly white. The results may not extrapolate to other ethnicities. There is a chance that the effects of one of the medications was carried over to the next phase of the trial as it was a crossover study. 

What’s next?

Preventing hypoglycemia in type 1 diabetes patients is important, please discuss any concerns with your doctor. 

Published By :

Journal of the American Medical Association (JAMA)

Date :

Jul 04, 2017

Original Title :

Effect of Insulin Degludec vs Insulin Glargine U100 on Hypoglycemia in Patients With Type 1 Diabetes: The SWITCH 1 Randomized Clinical Trial.

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