Switching to insulin degludec from other basal insulins

The aim of this study was to investigate blood glucose control and rates of hypoglycemia (dangerously low blood glucose levels) when diabetic patients were switched from their basal insulin to insulin degludec (Tresiba). The main finding of this study was that patients who were switched to insulin degludec had improved blood glucose control without increasing hypoglycemia risk.

In type 1 diabetes (T1D), the body stops making insulin (the hormone that controls blood glucose). Therefore, the treatment of T1D is insulin. Basal insulin is given daily. This controls blood glucose between meals. Extra insulin is given at mealtimes (bolus) to control blood glucose after eating.

In type 2 diabetes (T2D), the body still produces insulin but it does not work properly. Therefore, there are many different drugs that can treat T2D. These drugs do not always work. In these cases, insulin is then used to treat T2D.

There are many different types of basal insulin produced by different pharmaceutical companies. These include degludec (Tresiba), detemir (Levemir) and glargine (Lantus). The main side effects of insulin are weight gain and hypoglycemia. It is not known if switching to insulin degludec from another basal insulin could improve blood glucose control and reduce hypoglycemia risk.

This study included 2550 patients with either T1D or T2D. They were switched to insulin degludec from another basal insulin.

Patients with T1D who already had good blood glucose control had a 23% reduction in rates of hypoglycemia by 12 months. They had no change in their blood glucose control. Patients with T2D who already had good blood glucose control had a 73% decrease in rates of hypoglycemia. Both T1D and T2D patients required an average of 5.4 – 6.5 units less insulin by 12 months.  

Patients who had poor blood glucose control at the time of the switch had significant reductions in HbA1c (a blood test that measures the average blood glucose level in the past 3 months). There was no change in the rate of hypoglycemia or total dose of insulin in these patients.

The authors concluded that switching to insulin degludec reduced the rates of hypoglycemia in patients with good blood glucose control and improved blood glucose control in patients who had poor control.

This study was funded by Novo Nordisk A/S, the developer of insulin degludec.