In a nutshell
The aim of this study was to compare the effectiveness and safety of insulin degludec/insulin aspart (IDegAsp) combination once daily (OD) versus insulin glargine (IGlar) U100 OD+insulin aspart (IAsp) OD in patients with type 2 diabetes (T2D). The main finding of this study was that IDegAsp achieved similar blood sugar control and significantly less nighttime hypoglycemia compared to IGlar + IAsp.
With long-standing T2D, many patients require insulin therapy. There are many different types of insulins such as long-acting, short-acting etc. Treatment is started with basal insulin, also known as background insulin, which controls blood sugar between meals. If blood sugar is not sufficiently controlled with just basal insulin, additional fast-acting insulin is given at meal times.
IGlar (Lantus) is a basal insulin, given once a day. IAsp (NovoLog/NovoRapid) is a fast-acting insulin given at meal times. IDegAsp (Ryzodeg) is a combined insulin injection containing both basal insulin and fast-acting insulin. One important side effect from insulin treatment is hypoglycemia. It is still not known if the IDegAsp combination is as effective and safe as IGlar and IAsp taken separately.
Methods & findings
This study included 532 patients with T2D. Patients were randomly assigned to receive either IDegAsp or IGlar+IAsp for 38 weeks. Blood sugar control was measured by HbA1c (blood test of average blood sugar levels for last 3 months). All patients who had a HbA1c of greater than 7% at week 26, had their dose increased by receiving their treatment twice a day.
Both treatment groups had similar HbA1c levels throughout the study. When treatment was intensified at week 26, both groups saw similar decreases in HbA1c levels. Fasting blood glucose levels were also similar in both groups.
By the end of the trial, those on IDegAsp required 6.6% less insulin than those taking IGlar+IAsp to achieve target HbA1c. There was a 39% reduction in the rate of nighttime hypoglycemia in patients treated with IDegAsp versus those treated with IGlar+IAsp during the entire duration of the study.
The bottom line
The authors concluded that IDegAsp achieved similar blood sugar control to IGlar+IAsp while causing less nighttime hypoglycemia.
The fine print
This study was funded by Novo Nordisk, the developer of IDegAsp and IAsp
Published By :
Diabetes Research and Clinical Practice
Nov 15, 2018
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