title: Insulin degludec requires lower bolus insulin doses than does insulin glargine in Japanese diabetic patients with insulin-dependent state.
abstract: BACKGROUND
  The study presents a comparison of the glucose-lowering effects, glycemic variability, and insulin doses during treatment with insulin degludec or insulin glargine.
  
  
  METHODS
  In this open-label, single-center, 2-way crossover study, 13 Japanese diabetic outpatients in the insulin-dependent state on basal-bolus therapy were assigned to receive either insulin glargine followed by insulin degludec, or insulin degludec followed by insulin glargine. Basal insulin doses were fixed in principle, and patients self-adjusted their bolus insulin doses. Seventy-two-hour continuous glucose monitoring was performed 2 weeks after switching the basal insulin.
  
  
  RESULTS
  Mean blood glucose (mg/dL) was not significantly different between insulin degludec and insulin glargine over 48 hours (141.8 ± 35.2 vs 151.8 ± 43.3), at nighttime (125.6 ± 40.0 vs 124.7 ± 50.4), or at daytime (149.3 ± 37.1 vs 163.3 ± 44.5). The standard deviation (mg/dL) was also similar (for 48 hours: 48.9 ± 19.4 vs 50.3 ± 17.3; nighttime: 18.7 ± 14.3 vs 13.7 ± 6.7; daytime: 49.3 ± 20.0 vs 44.3 ± 17.7). Other indices of glycemic control, glycemic variability, and hypoglycemia were similar for both insulin analogs. Total daily insulin dose (TDD) and total daily bolus insulin dose (TDBD) were significantly lower with insulin degludec than with insulin glargine (TDD: 0.42 ± 0.20 vs 0.46 ± 0.22 U/kg/day, P = .028; TDBD: 0.27 ± 0.13 vs 0.30 ± 0.14 U/kg/day, P = .036).
  
  
  CONCLUSIONS
  Insulin degludec and insulin glargine provided effective and stable glycemic control. Insulin degludec required lower TDD and TDBD in this population of patients.
authors.affiliation: Center for Clinical Pharmacy and Clinical Sciences, School of Pharmacy, Kitasato University, Tokyo, Japan Diabetes Center, Kitasato Institute Hospital, Tokyo, Japan.
authors.forename: Manaho
authors.initials: M
authors.lastname: Komuro
authors.affiliation: Center for Clinical Pharmacy and Clinical Sciences, School of Pharmacy, Kitasato University, Tokyo, Japan Diabetes Center, Kitasato Institute Hospital, Tokyo, Japan.
authors.forename: Gaku
authors.initials: G
authors.lastname: Inoue
authors.affiliation: Diabetes Center, Kitasato Institute Hospital, Tokyo, Japan.
authors.forename: Mitsuhisa
authors.initials: M
authors.lastname: Tabata
authors.affiliation: Diabetes Center, Kitasato Institute Hospital, Tokyo, Japan.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Yamada
authors.affiliation: Center for Clinical Pharmacy and Clinical Sciences, School of Pharmacy, Kitasato University, Kanagawa, Japan.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Atsuda
authors.affiliation: Center for Clinical Pharmacy and Clinical Sciences, School of Pharmacy, Kitasato University, Tokyo, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Matsubara
authors.affiliation: Diabetes Center, Kitasato Institute Hospital, Tokyo, Japan.
authors.forename: Junichiro
authors.initials: J
authors.lastname: Irie
authors.affiliation: Diabetes Center, Kitasato Institute Hospital, Tokyo, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Uchida
authors.affiliation: Diabetes Center, Kitasato Institute Hospital, Tokyo, Japan.
authors.forename: Chikako
authors.initials: C
authors.lastname: Nakajima
authors.affiliation: Diabetes Center, Kitasato Institute Hospital, Tokyo, Japan.
authors.forename: Hisa
authors.initials: H
authors.lastname: Izumi
authors.affiliation: Diabetes Center, Kitasato Institute Hospital, Tokyo, Japan.
authors.forename: Mariko
authors.initials: M
authors.lastname: Shimada
authors.affiliation: Diabetes Center, Kitasato Institute Hospital, Tokyo, Japan yamada-s@insti.kitasato-u.ac.jp.
authors.forename: Satoru
authors.initials: S
authors.lastname: Yamada
mesh_terms: D044466:Asian People; D001786:Blood Glucose / Q000032:analysis; D018592:Cross-Over Studies; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced / Q000453:epidemiology; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D000069036:Insulin Glargine / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D049528:Insulin, Long-Acting / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D049528:Insulin, Long-Acting; D000069036:Insulin Glargine; C571886:insulin degludec
keywords: clinical trial; continuous glucose monitoring; insulin degludec; insulin glargine; insulin therapy