Department of Endocrinology and Diabetes, Yokohama City University Medical Center, Yokohama 232-0024, Japan.
Department of Endocrinology and Metabolism, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan.
Endocr J. 2019 Nov 28;66(11):971-982. doi: 10.1507/endocrj.EJ18-0309. Epub 2019 Jul 4.
The short-term efficacy and safety of insulin degludec U100 (IDeg) in patients with type 2 diabetes have not been reported widely. We compared insulin IDeg and insulin glargine U100 (IGla) for glycemic control and glucose variability in hospitalized patients with type 2 diabetes. In an open-label, multicenter, randomized controlled trial, 74 patients were randomly assigned to either the IDeg (36 patients) or IGla (38 patients) group and were administered with basal-bolus therapy during hospitalization. Following the start of the treatment, on day 11, glucose variability was assessed by continuous glucose monitoring. A fasting blood glucose level of 110 mg/dL and 2-hour postprandial blood glucose level of 180 mg/dL throughout at least one day during the observation period were achieved in 31.3% (10/32) and 30.6% (11/36) of the patients in the IDeg and IGla groups, respectively. The 6-point self-monitoring of blood glucose profiles showed a significant difference between the two groups. On day 7, the intra-day variation was larger in the IDeg group than in the IGla group. The incidence of hypoglycemia or glucose variability was comparable in the two groups. This study suggests that short-term efficacy and safety of IDeg and IGla in patients with type 2 diabetes during the initial phase of basal-bolus therapy were comparable, and these results can help in deciding which treatment to opt for.
胰岛素德谷胰岛素 U100(IDeg)在 2 型糖尿病患者中的短期疗效和安全性尚未广泛报道。我们比较了胰岛素 IDeg 和胰岛素甘精 U100(IGla)在 2 型糖尿病住院患者中的血糖控制和血糖变异性。在一项开放标签、多中心、随机对照试验中,74 名患者被随机分配至 IDeg(36 名患者)或 IGla(38 名患者)组,并在住院期间接受基础-餐时胰岛素治疗。治疗开始后第 11 天,通过连续血糖监测评估血糖变异性。在观察期间,至少有一天的空腹血糖水平为 110mg/dL 和餐后 2 小时血糖水平为 180mg/dL 的患者在 IDeg 和 IGla 组中的比例分别为 31.3%(10/32)和 30.6%(11/36)。6 点自我血糖监测谱显示两组间存在显著差异。在第 7 天,IDeg 组的日内变异性大于 IGla 组。两组间低血糖或血糖变异性的发生率相当。本研究提示,在基础-餐时胰岛素治疗的初始阶段,IDeg 和 IGla 治疗 2 型糖尿病的短期疗效和安全性相当,这些结果有助于决定选择哪种治疗方案。