Endocrinology and Metabolism

Original Article

Clinical Study
Favorable Glycemic Control with Once-Daily Insulin Degludec/Insulin Aspart after Changing from Basal Insulin in Adults with Type 2 Diabetes: Han Na Jang, Ye Seul Yang, Seong Ok Lee, Tae Jung Oh, Bo Kyung Koo, Hye Seung Jung; Endocrinol Metab. 2019;34(4):382-389. Published online December 23, 2019; DOI: https://doi.org/10.3803/EnM.2019.34.4.382

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Background

Conflicting results have been reported on the efficacy of insulin degludec/insulin aspart (IDegAsp) compared to basal insulin in type 2 diabetes. We investigated the effects of changing basal insulin to IDegAsp on glycemic control and sought to identify factors related to those effects.

Methods

In this retrospective study of patients from three referral hospitals, patients with type 2 diabetes using basal insulin with hemoglobin A1c (HbA1c) levels less than 11.0% were enrolled. Basal insulin was replaced with IDegAsp, and data were analyzed from 3 months before to 3 months after the replacement.

Results

Eighty patients were recruited (52.5% male; mean age, 67.0±9.8 years; mean duration of diabetes, 18.9±8.5 years; mean HbA1c, 8.7%±1.0%). HbA1c levels increased during 3 months of basal insulin use, but significantly decreased after changing to IDegAsp (8.28%±1.10%, P=0.0001). The reduction was significant at 6 months in 35 patients whose longer-term data were available. Patients with a measured fasting plasma glucose (m-FPG) lower than their predicted FPG (p-FPG) by regression from HbA1c showed a significant HbA1c reduction caused by the change to IDegAsp, even without a significantly increased insulin dose. However, patients whose m-FPG was higher than their p-FPG did not experience a significant HbA1c reduction, despite a significantly increased insulin dose. Furthermore, the HbA1c reduction caused by IDegAsp was significant in patients with low fasting C-peptide levels and high insulin doses.

Conclusion

We observed a significant glucose-lowering effect by replacing basal insulin with IDegAsp, especially in patients with a lower m-FPG than p-FPG.

Citations

Citations to this article as recorded by

Evaluation of the efficiency of insulin degludec/insulin aspart therapy in controlling hyperglycemia and hypoglycemia in patients with type 2 diabetes mellitus: a real-life experience
Gökçen Güngör Semiz, İsmail Selimoğlu, Mehmet Emin Arayici, Serkan Yener, Abdurrahman Çömlekçi, Tevfik Demir
International Journal of Diabetes in Developing Countries.2023; 43(4): 544. CrossRef
Low fasting glucose‐to‐estimated average glucose ratio was associated with superior response to insulin degludec/aspart compared with basal insulin in patients with type 2 diabetes
Han Na Jang, Ye Seul Yang, Tae Jung Oh, Bo Kyung Koo, Seong Ok Lee, Kyong Soo Park, Hak Chul Jang, Hye Seung Jung
Journal of Diabetes Investigation.2022; 13(1): 85. CrossRef
Efficacy and Safety of Insulin Degludec/Insulin Aspart (IDegAsp) in Type 2 Diabetes: Systematic Review and Meta-Analysis
Brenda C Edina, Jeremy R Tandaju, Lowilius Wiyono
Cureus.2022;[Epub] CrossRef
Comparing time to intensification between insulin degludec/insulin aspart and insulin glargine: A single-center experience from India
Rajiv Kovil
Journal of Diabetology.2022; 13(2): 171. CrossRef
Efficacy and Safety of Insulin Degludec/Insulin Aspart Compared with a Conventional Premixed Insulin or Basal Insulin: A Meta-Analysis
Shinje Moon, Hye-Soo Chung, Yoon-Jung Kim, Jae-Myung Yu, Woo-Ju Jeong, Jiwon Park, Chang-Myung Oh
Metabolites.2021; 11(9): 639. CrossRef
Fear of Hypoglycemia in Adults with diabetes mellitus switching to Treatment with IDegAsp Co-formulation to Examine real-world setting: an observational study (The HATICE study)
Ulaş Serkan Topaloğlu, Hatice Kayış Topaloğlu, Melih Kızıltepe, Mesut Kılıç, Sami Bahçebaşı, Sibel Ata, Şeyma Yıldız, Yasin Şimşek
Drug Metabolism and Drug Interactions.2021; 36(2): 129. CrossRef
Response: Favorable Glycemic Control with Once-Daily Insulin Degludec/Insulin Aspart after Changing from Basal Insulin in Adults with Type 2 Diabetes (Endocrinol Metab 2019; 34:382-9, Han Na Jang et al.)
Han Na Jang, Hye Seung Jung
Endocrinology and Metabolism.2020; 35(1): 194. CrossRef
Letter: Favorable Glycemic Control with Once-Daily Insulin Degludec/Insulin Aspart after Changing from Basal Insulin in Adults with Type 2 Diabetes (Endocrinol Metab 2019; 34:382-9, Han Na Jang et al.)
Sang Youl Rhee
Endocrinology and Metabolism.2020; 35(1): 192. CrossRef
Fear of hypoglycemia in adults with diabetes mellitus switching to treatment with IDegAsp co-formulation to examine real-world setting: an observational study (The HATICE study)
Ulaş Serkan Topaloğlu, Hatice Kayış Topaloğlu, Melih Kızıltepe, Mesut Kılıç, Sami Bahçebaşı, Sibel Ata, Şeyma Yıldız, Yasin Şimşek
Drug Metabolism and Personalized Therapy.2020;[Epub] CrossRef

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