Division of Diabetes, Endocrinology, and Metabolism, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo, 663-8501, Japan,
Diabetes Ther. 2013 Dec;4(2):461-72. doi: 10.1007/s13300-013-0048-5. Epub 2013 Nov 27.
Insulin degludec is a new, ultra-long-acting basal insulin. The aim of this study was to analyze the changes of basal insulin dose and blood glucose profile in basal-bolus therapy of type 1 diabetes mellitus (T1DM) at the switching of basal insulin from insulin glargine or detemir to insulin degludec.
Sixteen patients with T1DM were enrolled. The patients underwent continuous glucose monitoring before and after the switching of insulin glargine or detemir to degludec. Ten patients treated with insulin glargine or detemir twice daily, were switched to insulin degludec with 80-90% of the prior insulin dose. The remaining six patients treated with insulin glargine once daily, were switched to insulin degludec without down titration. The changes of daily insulin dose and glycated hemoglobin (HbA1c) were also examined for 12 weeks after switching to insulin degludec.
In the patients switched from twice-daily basal insulin, no significant difference was found between before and after switching in the blood glucose profile. In the once-daily group, blood glucose levels showed a tendency to decrease after switching to the degludec treatment. During the study period, total daily insulin dose (TDD) and total daily basal insulin dose (TBD) decreased significantly in the twice-daily group, and TDD and TBD showed a tendency to decrease after switching to degludec in the once-daily group. In both groups, the changes of HbA1c were not significantly different.
It is possible to achieve similar glycemic control with once-daily injection and lower doses of insulin degludec in patients with T1DM who have been treated with insulin glargine or detemir.
德谷胰岛素是一种新型的超长效基础胰岛素。本研究旨在分析在从甘精胰岛素或地特胰岛素切换为德谷胰岛素的基础-餐时胰岛素方案中，1 型糖尿病（T1DM）患者基础胰岛素剂量和血糖谱的变化。
纳入 16 例 T1DM 患者。患者在切换为德谷胰岛素之前和之后均进行了连续血糖监测。10 例接受甘精胰岛素或地特胰岛素每日两次治疗的患者，以 80-90%的原胰岛素剂量切换为德谷胰岛素。其余 6 例接受甘精胰岛素每日一次治疗的患者，不进行剂量下调直接切换为德谷胰岛素。切换为德谷胰岛素后 12 周，还检查了每日胰岛素剂量和糖化血红蛋白（HbA1c）的变化。
在从每日两次基础胰岛素切换的患者中，切换前后血糖谱无显著差异。在每日一次组中，切换为德谷胰岛素后血糖水平呈下降趋势。在研究期间，每日总胰岛素剂量（TDD）和每日总基础胰岛素剂量（TBD）在每日两次组中显著下降，而每日一次组在切换为德谷胰岛素后 TDD 和 TBD 呈下降趋势。两组患者的 HbA1c 变化均无显著差异。
在接受甘精胰岛素或地特胰岛素治疗的 T1DM 患者中，每日一次注射和较低剂量的德谷胰岛素可能实现类似的血糖控制。
