학술논문

Switching to Once-Daily Insulin Degludec/Insulin Aspart from Basal Insulin Improves Postprandial Glycemia in Patients with Type 2 Diabetes Mellitus: Randomized Controlled Trial
Document Type
Article
Source
Diabetes and Metabolism Journal (DMJ). Aug 31, 2020 44(4):532
Subject
Diabetes mellitus
type 2
Hypoglycemia
Insulin degludec
insulin aspart drug combination
Randomized controlled trial
Language
Korean
ISSN
2233-6079
Abstract
Background: To explore the efficacy and safety of switching from once-daily basal insulin therapy to once-daily pre-meal injec-tion insulin degludec/insulin aspart (IDegAsp) with respect to the glycemic control of participants with type 2 diabetes mellitus (T2DM). Methods: In this multicenter, open-label, prospective, randomized, parallel-group comparison trial, participants on basal insulin therapy were switched to IDegAsp (IDegAsp group; n=30) or continued basal insulin (Basal group; n=29). The primary end-point was the superiority of IDegAsp in causing changes in the daily blood glucose profile, especially post-prandial blood glucose concentration after 12 weeks. Results: Blood glucose concentrations after dinner and before bedtime were lower in the IDegAsp group, and the improvement in blood glucose before bedtime was significantly greater in the IDegAsp group than in the Basal group at 12 weeks (-1.7±3.0 mmol/L vs. 0.3±2.1 mmol/L, P<0.05). Intriguingly, glycemic control after breakfast was not improved by IDegAsp injection before break-fast, in contrast to the favorable effect of injection before dinner on blood glucose after dinner. Glycosylated hemoglobin signifi-cantly decreased only in the IDegAsp group (58 to 55 mmol/mol, P<0.05). Changes in daily insulin dose, body mass, and record-ed adverse effects, including hypoglycemia, were comparable between groups. Conclusion: IDegAsp was more effective than basal insulin at reducing blood glucose after dinner and before bedtime, but did not increase the incidence of hypoglycemia. Switching from basal insulin to IDegAsp does not increase the burden on the patient and positively impacts glycemic control in patients with T2DM.