Impact of Insulin Degludec in Type 2 Diabetes: Real-World Data on Effectiveness and Safety

IntroductionReal-world evidence on effectiveness and safety of insulin degludec (IDeg) in patients with diabetes is a priority. The aim of the study was to evaluate patterns of use and the long-term effectiveness and safety of IDeg in routine clinical practice.MethodsThis was an observational longitudinal study. A retrospective chart review of all patients with type 2 diabetes treated with IDeg was performed and temporal trends in clinical outcomes were assessed. All data was stratified by treatment modality: the switch group consisted of patients already treated with another basal insulin before initiating IDeg; the add-on group consisted of basal insulin-naive patients.ResultsOverall, 247 patients were analyzed (55 in the add-on group and 192 in the switch group), mean age 67.010.9years ,and diabetes duration 16.3 +/- 8.9years. Median (interquartile range) follow-up was 9.7 (8.0-11.9) months. In the add-on group, improvements were found in glycated hemoglobin (HbA1c) (- 1.68%; p<0.0001), fasting blood glucose (FBG) (- 64.7mg/dL; p<0.0001), post-prandial glucose (PPG) (- 81.1mg/dl; p<0.0001), and glycemic variability (i.e., standard deviation of blood glucose) (-11.6mg/dl; p=0.04). Even in the switch group, improvements were found in HbA1c (-0.57%; p<0.0001), FBG (-28.1mg/dL; p<0.0001), and PPG (-22.6mg/dl; p=0.001). Body weight increase during the follow-up was not statistically significant vs. baseline in both groups. Benefits on overall, nocturnal, and severe hypoglycemia were found in the switch group.Conclusion p id=Par4 These real-world data documented that initiating IDeg or switching to IDeg from other basal insulins in type 2 diabetes was associated with significant improvement in metabolic control without significant weight gain; a decrease in the risk of hypoglycemia was observed when switching to IDeg from another basal insulin.