title: An Open-label Longitudinal Study on the Efficacy of Switching from Insulin Glargine or Detemir to Degludec in Type 2 Diabetes Mellitus.
abstract: OBJECTIVE
  Insulin degludec (IDeg), a new long-acting basal insulin, and FlexTouch, a new injection device, recently became available in Japan. The efficacy and usefulness of IDeg and FlexTouch, compared with insulin glargine or detemir, were assessed in patients with type 2 diabetes mellitus.
  
  
  METHODS
  We performed an open-label longitudinal trial in 20 patients. After informed consent was obtained, all subjects recorded their self-monitoring data of the blood glucose (BG) level; thereafter, basal insulin was replaced by an IDeg-prefilled FlexTouch with the same dose and duration of time (2 weeks). After using FlexTouch, the patients were provided a device-specific questionnaire.
  
  
  RESULTS
  The patients were divided into two groups according to the dose of basal insulin (≥10 U and <10 U). Although the mean fasting BG levels were unchanged, the mean BG levels before basal insulin injection and its standard deviation were significantly reduced after switching to IDeg in the patients receiving a higher dose of basal insulin (mean BG before basal insulin injection: 164 to 144 mg/dL, p=0.002; mean standard deviation: 32 to 22, p=0.031); however, this difference was not observed in the patients receiving a lower dose. The patients with a shorter duration of diabetes and a single injection of insulin preferred FlexTouch compared with conventional insulin devices.
  
  
  CONCLUSIONS
  Replacing basal insulin with IDeg is useful for the stable and accurate control of blood glucose levels in type 2 diabetes for those receiving a higher dose of basal insulin. Furthermore, the patients with a shorter duration of diabetes and a single insulin injection preferred FlexTouch.
authors.affiliation: Department of Internal Medicine 1, Shimane University Faculty of Medicine, Japan.
authors.forename: Ippei
authors.initials: I
authors.lastname: Kanazawa
authors.forename: Masakazu
authors.initials: M
authors.lastname: Notsu
authors.forename: Ken-ichiro
authors.initials: K
authors.lastname: Tanaka
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Kiyohara
authors.forename: Yuko
authors.initials: Y
authors.lastname: Tada
authors.forename: Toshitsugu
authors.initials: T
authors.lastname: Sugimoto
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis / Q000187:drug effects*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D004334:Drug Administration Schedule; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D007328:Insulin / Q000097:blood*; D000069036:Insulin Glargine / Q000008:administration & dosage*; D049528:Insulin, Long-Acting / Q000008:administration & dosage*; D007564:Japan / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; D000069036:Insulin Glargine; D049528:Insulin, Long-Acting; C571886:insulin degludec