Background Degludec is a new-generation basal insulin analogue with a longer acting, better pharmacokynetic and pharmacodynamic profile and with four times less variability than its comparative insulin, glargine.
Purpose We evaluated the impact in glycated haemoglobin (HbA1c) and varibility of glucose levels after the change to degludec from any other basal insulin.
Material and methods A retrospective observational study was made using 129 diabetic patients from the Diabetes Day Hospital, using the features described in the results to characterise them. Three months’ later the variation of the levels of HbA1c, body mass and insulin units were monitored. In addition, we chose a 79-patient subgroup to analyse glycaemia variability, using capillary glucose levels 3 consecutive days before the change to degludec and after 12 weeks.
Results One-hundred and twenty-nine patients were included in the study, 32,6% females and 67.4% males, with an average age of 57.1±17.3 years. Between them, 25.6% had diabetes type I and 74.4% diabetes type II, and an evolution of 14.7±8.6 years after the diagnosis, also with a body mass index of 30.8±5.1 kg/m2, and HbA1c levels of 8.67%±1.9%. The most common reasons to change the basal insulin were repetitive hypoglycaemias (34.9%), bad glucose sugar levels’ control (40.3%), glycaemia variability (16.3%) and the necessity of repeating the basal dose (8.5%). The previous treatment was basal insulin treatment (12.4%) versus basal bolus (87.6%). The results after a 3 month period with degludec are shown in table 1. No severe hypoglycaemias were reported.
Conclusion Above the HbA1c, new glycaemic control quality standards are being used to measure progress in the quality of life of diabetic patients with new treatments. All of them show a dramatic improvement after changing from glargine to degludec in only 3 months. Nevertheless, glargine is still the elected basal insulin for insulin-dependent diabetic patients, and more studies should be done to prove the superiority of degludec.
References and/or acknowledgements None.
No conflict of interest.
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