Clinical benefits of switching to insulin degludec irrespective of previous basal insulin therapy in people with Type 1 or Type 2 diabetes: evidence from a European, multicentre, retrospective, non‐interventional study (EU‐TREAT). Issue 7 (2nd May 2019)

• Record Type: Journal Article
• Authors: Knudsen, S. T.; Lapolla, A.; Schultes, B.; Tentolouris, N.; Catarig, A.‐M.; Wolden, M. L.; Siegmund, T.
• Is Part Of: Diabetic medicine. Volume 36:Issue 7(2019)
• Page Start: 868
• Page End: 877
• Publication Date: 2019-05-02
• Subjects: Diabetes -- Periodicals; 616.462
• DOI: 10.1111/dme.13976
• Languages: English
• ISSNs: 0742-3071

Abstract

Abstract: Aims: To investigate whether the benefits of switching to insulin degludec observed in the European retrospective chart review study EU‐TREAT were dependent on the previous basal insulin used. Methods: People with Type 1 or Type 2 diabetes were switched to insulin degludec from other basal insulins ≥6 months before data collection. Participants were stratified into three groups based on their previous basal insulin: insulin glargine 100 units/ml (Type 1: n =888; Type 2: n =259); insulin detemir (Type 1: n =726; Type 2: n =415); and neutral protamine Hagedorn (Type 1: n =53; Type 2: n =95). Their glycaemic control and hypoglycaemia incidence at 6 and 12 months post‐switch vs pre‐switch was then evaluated. Results: Significant HbA1c reductions were achieved in all previous basal insulin groups for participants with Type 1 diabetes [insulin glargine 100 units/ml: −2.08 mmol/mol (−0.19%); insulin detemir: −2.40 mmol/mol (−0.22%)] and those with Type 2 diabetes [insulin glargine 100 units/ml: −5.90 mmol/mol (–0.54%); insulin detemir: −6.01 mmol/mol (−0.55%); neutral protamine Hagedorn: −2.73 mmol/mol (−0.25%)] at 6 months, except for the relatively small neutral protamine Hagedorn group in those with Type 1 diabetes [−1.75 mmol/mol (−0.16%)], where statistical significance was not reached. At 6 months in the Type 1 diabetes group, switching to insulin degludec from insulin glargine 100 units/ml resulted in significantly lower hypoglycaemia rates across all hypoglycaemia categories; for the insulin detemir group, this significance was also observed for severe and nocturnal non‐severe hypoglycaemia, while the low number of people in the neutral protamine Hagedorn group resulted in nonsignificant reductions in hypoglycaemia rates. At 6 months in the people with Type 2 diabetes, switching to insulin degludec resulted in significantly lower rates of hypoglycaemia across all categories for all groups. Similar outcomes were observed at 12 months. Conclusions: Switching to insulin degludec from other basal insulins can improve glycaemic control and/or reduce hypoglycaemia risk in people with diabetes (although there was a nonsignificant reduction in HbA1c and hypoglycaemia rates for the neutral protamine Hagedorn group in Type 1 diabetes) under routine care. What's new?: The EU‐TREAT study previously demonstrated that switching to insulin degludec from other basal insulins improved glycaemic control and significantly lowered the risk of hypoglycaemia in people with Type 1 or Type 2 diabetes. In the present study, people from EU‐TREAT were stratified into three groups, based on type of previous basal insulin used. Results showed that people who switched to insulin degludec from glargine U100 or detemir benefitted from improved glycaemic control and a lowered risk of hypoglycaemia at lower or similar insulin doses. This study indicates that insulin degludec can offer improved glycaemic control and reduced hypoglycaemia risk, irrespective of previous basal insulin therapy.