title: Degludec is superior to glargine in terms of daily glycemic variability in people with type 1 diabetes mellitus.
abstract: To investigate the differences in glycemic variability between the long-acting insulins glargine and degludec using continuous glucose monitoring, we conducted an open-label, multicenter, prospective, observational study that enrolled 21 participants with type 1 diabetes mellitus currently receiving basal-bolus insulin therapy with glargine. To avoid the potential influence of diet and exercise on glycemic control, all participants were housed and monitored within the hospital for the duration of the study. Once glycemic control was achieved with glargine, glycemic variability was evaluated using continuous glucose monitoring for 3 days. Glargine was then replaced by degludec and glycemic variability again assessed via continuous glucose monitoring. The primary outcome measure of mean amplitude of glycemic excursions was significantly reduced with degludec (p = 0.028), as was area under the curve for daily blood glucose level <70 mg/dL (p = 0.046). The required insulin dose was reduced up to 25% in the degludec group, although 24-h mean glucose concentrations were not different between groups. In conclusion, once or twice daily glargine was successfully replaced by a daily injection of degludec. When replacing glargine with degludec, a lower dose should be utilized to avoid hypoglycemia. Degludec is an effective and promising long-acting insulin that reduced hypoglycemia and daily blood glucose variability in participants with type 1 diabetes.
authors.affiliation: Division of Rheumatology, Endocrinology and Nephrology, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Japan.
authors.forename: Chiho
authors.initials: C
authors.lastname: Yamamoto
authors.forename: Hideaki
authors.initials: H
authors.lastname: Miyoshi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Fujiwara
authors.forename: Reina
authors.initials: R
authors.lastname: Kameda
authors.forename: Mei
authors.initials: M
authors.lastname: Ichiyama
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nomoto
authors.forename: Hiraku
authors.initials: H
authors.lastname: Kameda
authors.forename: Akinobu
authors.initials: A
authors.lastname: Nakamura
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Atsumi
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism*; D002940:Circadian Rhythm; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced; D000069036:Insulin Glargine / Q000627:therapeutic use*; D049528:Insulin, Long-Acting / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged
chemical_list: D001786:Blood Glucose; D049528:Insulin, Long-Acting; D000069036:Insulin Glargine; C571886:insulin degludec