3 years ago

A European, multicentre, retrospective, non-interventional study (EU-TREAT) of the effectiveness of insulin degludec after switching basal insulin in a population with type 1 or type 2 diabetes

Tra-Mi Phan, Thorsten Siegmund, Annunziata Lapolla, Michael Lyng Wolden, Rudolf Prager, Bernd Schultes, Nikolaos Tentolouris, Søren T. Knudsen,
Aims To evaluate the clinical effectiveness of switching to insulin degludec (IDeg) in insulin-treated patients with either T1DM or T2DM, in conditions of routine clinical care. Materials and methods This was a multicentre, retrospective, chart review study. All patients had their basal insulin switched to IDeg at least 6 months before the start of data collection. Baseline was defined as the most recent recording during the 3-month period before first prescription of IDeg. Values are mean [95%CI]. Results T1DM (n=1717): HbA1c decreased by −2.2 [−2.6; −2.0] mmol/mol (−0.20 [−0.24; −0.17]%) at 6 months versus baseline (P<0.001). Rate ratio of overall (0.79 [0.69; 0.89]), non-severe nocturnal (0.54 [0.42; 0.69]) and severe hypoglycaemia (0.15 [0.09; 0.24]) was significantly lower in the 6-month post-switch versus pre-switch periods (P<0.001 for all). Total daily insulin dose decreased by −4.88 [−5.52; −4.24]U (−11%) at 6 months versus baseline (P<0.001). T2DM (n=833): HbA1c decreased by −5.6 [−6.3; −4.7] mmol/mol (−0.51 [−0.58; −0.43]%) at 6 months versus baseline (P<0.001). Rate ratio of overall (0.39 [0.27; 0.58], P<0.001), non-severe nocturnal (0.10 [0.06; 0.16], P<0.001) and severe hypoglycaemia (0.075 [0.01; 0.43], P=0.004) was significantly lower in the 6-month post-switch versus pre-switch periods. Total daily insulin dose decreased by −2.48 [−4.24; −0.71]U (−3%) at 6 months versus baseline (P=0.006). Clinical outcomes for T1DM and T2DM at 12 months were consistent with the 6-month results. Conclusions This study demonstrates that switching patients to IDeg from other basal insulins improves glycaemic control and significantly reduces the risk of hypoglycaemia in routine clinical practice.

Publisher URL: http://onlinelibrary.wiley.com/resolve/doi

DOI: 10.1111/dom.13149

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