ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2017) 49 EP602 | DOI: 10.1530/endoabs.49.EP602

Real practice experience: Degludec vs Glargina U300

María Rosa Alhambra Expósito, Inmaculada Prior Sánchez, Paloma Moreno Moreno & M Ángeles Gálvez Moreno

Hospital Universitario Reina Sofía, Córdoba, Spain.

Background: In last year, different analogues of very long duration basal insulin have appeared, which favors the flexibility in its use. Both ensure a decrease in the rate of hypoglycemia and improve glycemic control in clinical trials. However, in real practice we have few data in real practice.

Objective: To compare the two ultralente insulin analogues in real practice. To analyze if they are cost effective.

Material and methods: Observational study including patients with type 2 diabetes, referred to Diabetes Day Hospital (DDH) to management diabetes in which we changed the basal insulin regimen to Tresiba® o Toujeo®. We revised them 3–6 months from change.

Results: 123 patients were included (68.3% Toujeo® vs 41.7% Tresiba®). Mean age: 52.60±19.67 years; ♂-58.5%. Most patients (83.7%) were with glargina basal insulin regimen. After 3 to 6 months from change in the insulin treatment, basal blood glucose reduced significantly in both groups ((to average of 233.04±87.80 mg/dl down from 132.39±66.03 mg/dl in Toujeo®; P<0.001) and (to 238.44±86.28 mg/dl low from 143.11±66.90 mg/dl, in Tresiba®; P<0.001)). We also observed a significant reduction in HbA1c levels ((average reduction in Toujeo® of 2.03±2.28%, P<0.001) and (average decrease of 1.19±1.46%, in Tresiba®; P<0.001)). However, comparatively no differences in efficacy were found between groups (0.49±0.32%; P=0.185). At the end of follow-up, the number of units of Toujeo® increased an average of +5.08±18.55 UI (P=0.014) while insulin requirements in Tresiba® decreased an average of −4.20 28±7.36 UI (P 0.001). With regard to the cost, an average cost of 436.84±252.57 € per person (Toujeo® group) vs 601.82±419.61 € per person (Tresiba® group), (mean difference: 164.98 €, P=0.027).

Conclusion: Both basal insulin analogues are effective in reducing basal glycemia and HbA1c. Although there is an increase in insulin requirements when switching to Toujeo®. Potential economic savings are realized by using Toujeo® instead of Tresiba®.

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