title: Efficacy and safety of switching from insulin glargine to insulin degludec in young people with type 1 diabetes.
abstract: We evaluated the efficacy and safety of switching to insulin degludec (IDeg) from insulin glargine (IGlar) as basal-bolus therapy in young people with type 1 diabetes. The subjects were 36 patients, 21.3±1.0 years of age, with type 1 diabetes. IGlar had previously been injected once daily in 25 patients and twice daily in 11. They were then switched from IGlar to once-daily injection of IDeg. Both fasting plasma glucose (FPG) and HbA1c levels decreased significantly from 134±3.9 mg/dL and 7.9±0.2% at baseline to 116±2.2 mg/dL and 7.4±0.2% at 12 months after starting IDeg (P<0.0001 and P≤0.001, respectively). Overall and nocturnal hypoglycemia (PG<70 mg/dL) frequencies also decreased significantly from 4.9±0.7 and 2.0±0.3 times/month to 2.4±0.3 and 0.4±0.1 times/month at 12 months after starting IDeg (P≤0.005 and P<0.0005, respectively). The daily basal insulin dose was significantly reduced from 0.48±0.04 units/kg/day at baseline to 0.38±0.03 units/kg/day at the end of the study period (P<0.0001), which corresponded to 79.2% of the baseline value. Trends were similar in patients receiving the once-daily injection and those given twice-daily injections, but basal-insulin value reductions from baseline were more marked in patients receiving twice-daily injections of basal insulin (76.0% vs. 82.6% of the baseline value). These results suggest that switching from IGlar to an appropriate dose of IDeg may effectively control hyperglycemia while reducing the frequency of hypoglycemia episodes in young Japanese people with type 1 diabetes.
authors.affiliation: Department of Pediatrics, Nihon University School of Medicine, Tokyo 101-8309, Japan.
authors.forename: Tatsuhiko
authors.initials: T
authors.lastname: Urakami
authors.forename: Remi
authors.initials: R
authors.lastname: Kuwabara
authors.forename: Masako
authors.initials: M
authors.lastname: Aoki
authors.forename: Misako
authors.initials: M
authors.lastname: Okuno
authors.forename: Junichi
authors.initials: J
authors.lastname: Suzuki
mesh_terms: D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000187:drug effects; D002940:Circadian Rhythm; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D004334:Drug Administration Schedule; D057915:Drug Substitution; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D000069036:Insulin Glargine / Q000627:therapeutic use*; D049528:Insulin, Long-Acting / Q000008:administration & dosage* / Q000009:adverse effects*; D008297:Male; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D000069036:Insulin Glargine; D049528:Insulin, Long-Acting; C571886:insulin degludec