The emergence of a new generation of long-acting insulin analogues (insulin degludec -ID- and insulin glargine 300 U/ml -IG300-) has increased treatment options in type 1 diabetes (T1D), demonstrating in clinical trials better metabolic control with lower hypoglycemia rates.
Objectives: To assess characteristics of T1D patients who were given ID and IG300 in clinical practice and to evaluate their effect on metabolic control, weight, insulin dose and hypoglycemia, comparing results obtained.
Methods: Observational, retrospective study. We studied T1D patients whose habitual treatment had been modified. We analyzed anthropometric data (weight, BMI), biochemical parameters (fasting glycemia, HbA1c, lipid profile), insulin dose and number of hypoglycemic events per month (<5; 510; >10, initially and after 6 months.
Results: 38 patients: 50% women, age 38±12.7 years, BMI 25.8±3.9 kg/m2, T1D evolution time 14.9±8.6 years and HbA1c 7.4±0.8%. 57.9% initiated ID and 42.1% IG300. They presented: 7.9% hypertension, 13.2% retinopathy, 2.6% history of ischemic heart disease, 2.6% nephropathy and 0% neuropathy. Initially, there were no differences between the two groups, except for higher blood glucose in ID group (189.2±12.1 vs 144.3±22.4 mg/dl, P 0.003). There was a significant decrease in insulin dose with ID (29.05±9.25 vs 24.82±20.8 IU, P 0.010). There was a weight loss of 1.9±4.4 kg in patients with IG300, but not statistically significant. We observed a significant decrease in the number of hypoglycemia events in general (75% with >10 decreased to <5; P=0.009). When stratified by comparison groups, the significance is maintained with ID but not with IG300.
Conclusions: 1) ID group significantly decreased basal insulin dose. 2) We observed weight loss, not statistically significant, in IG300 patients. 3) There was significant reduction of hypoglycemia rates with both basal insulin analogues. 4) Further studies are needed to distinguish which type of patient benefits more from each insulin analogue.
20 - 23 May 2017
European Society of Endocrinology