Department of Endocrinology and Metabolism, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey.
Department Pediatric Endocrinology, Marmara University Faculty of Medicine, Istanbul, Turkey.
Front Endocrinol (Lausanne). 2021 Mar 12;12:616514. doi: 10.3389/fendo.2021.616514. eCollection 2021.
Insulin degludec/insulin aspart (IDegAsp) is a fixed-ratio co-formulation of insulin degludec (IDeg), which provides long-lasting basal insulin coverage, and insulin aspart (IAsp), which targets post-prandial glucose. This expert panel aimed to provide a practical and implementable guidance document to assist clinicians in prescribing IDegAsp in the diabetes management with respect to different patient populations including children and adults with type 1 diabetes (T1D) or type 2 diabetes (T2D) as well as pregnant, elderly and hospitalized patients and varying practice patterns (insulin-naive, insulin-treated, switching from basal, basal bolus and premix regimens). The experts recommended that IDegAsp can be used in insulin-naive T2D patients with poor glycemic control (HbA1c >8.5%) despite optimal oral antidiabetic drugs (OADs) as well as in insulin-treated T2D patients by switching from basal insulin, basal-bolus therapy or premixed insulins in relation to lower risk of nocturnal hypoglycemia, fewer injections and lower intraday glycemic variability, respectively. The experts considered the use of IDegAsp in children with T2D as a basal bolus alternative rather than as an alternative to basal insulin after metformin failure, use of IDegAsp in adult T1D patients as a simplified basal bolus regimen with lesser nocturnal hypoglycemia, fewer injections and better fasting plasma glucose control and in children with T1D as an alternative insulin regimen with fewer injection to increase treatment adherence. The proposed expert opinion provides practical information on use of IDegAsp in different patient populations and practice patterns to assist clinicians, which seems to compensate the need for easily implementable guidance on this novel insulin regimen.
德谷胰岛素/门冬胰岛素（IDegAsp）是德谷胰岛素（IDeg）和门冬胰岛素（IAsp）的固定比例复方制剂，可提供长效基础胰岛素覆盖，门冬胰岛素则针对餐后血糖。本专家小组旨在提供一份实用且可执行的指导文件，以协助临床医生在不同患者群体（包括 1 型糖尿病（T1D）或 2 型糖尿病（T2D）的儿童和成人、妊娠、老年和住院患者以及不同的实践模式（胰岛素初治、胰岛素治疗、从基础胰岛素、基础-餐时胰岛素和预混胰岛素转换）下使用 IDegAsp 进行糖尿病管理。专家建议，对于血糖控制不佳（HbA1c＞8.5%）且尽管已接受最佳口服降糖药（OAD）治疗的胰岛素初治 T2D 患者，以及在与夜间低血糖风险降低、注射次数减少和日内血糖变异性降低相关的情况下从基础胰岛素、基础-餐时胰岛素或预混胰岛素转换治疗的胰岛素治疗 T2D 患者，均可使用 IDegAsp。专家认为，在 T2D 儿童中，IDegAsp 可用作基础-餐时胰岛素替代方案，而非二甲双胍治疗失败后的基础胰岛素替代方案；在 T1D 成年患者中，IDegAsp 可作为简化的基础-餐时胰岛素方案，低血糖发生率更低、注射次数更少、空腹血糖控制更好；在 T1D 儿童中，IDegAsp 作为一种替代胰岛素方案，注射次数更少，可提高治疗依从性。本专家意见提供了在不同患者群体和实践模式下使用 IDegAsp 的实用信息，以协助临床医生，似乎弥补了对这种新型胰岛素方案的简单易行的指导的需求。
