Real-life experience of patients starting insulin degludec. A multicenter analysis of 1064 subjects from the German/Austrian DPV registry

被引：15

作者：

Bohn, Barbara ^{[1
,2
]}

Zimmermann, Artur ^{[3
]}

Wagner, Christian ^{[4
]}

Merger, Sigrun ^{[5
]}

Dunstheimer, Desiree ^{[6
]}

Kopp, Florian ^{[7
]}

Gollisch, Katja ^{[8
]}

Zindel, Volker ^{[9
]}

Holl, Reinhard W. ^{[1
,2
]}

机构：

[1] Univ Ulm, Inst Epidemiol & Med Biometry, ZIBMT, Albert Einstein Allee 41, D-89081 Ulm, Germany

[2] German Ctr Diabet Res DZD, Munich, Germany

[3] Specialized Diabet Practice, Bad Aibling, Germany

[4] Specialized Diabet Practice, Saaldorf, Germany

[5] Clin Coburg, Clin Endocrinol Diabetol Metab & Nutr Med, Med Clin 4, Coburg, Germany

[6] Clin Ctr Augsburg, Dept Pediat, Augsburg, Germany

[7] Clin Ctr Augsburg, Diabet Ctr, Augsburg, Germany

[8] Univ Gottingen, Dept Gastroenterol & Endocrinol, Gottingen, Germany

[9] Clin Bad Salzungen, Hosp Pediat & Adolescent Med, Bad Salzungen, Germany

来源：

DIABETES RESEARCH AND CLINICAL PRACTICE | 2017年 / 129卷

关键词：

Insulin degludec; Type; 1; diabetes; 2; Real-world data; TREAT-TO-TARGET; LONGACTING BASAL INSULIN; OPEN-LABEL; NAIVE PATIENTS; BOLUS TREATMENT; WEIGHT-GAIN; GLARGINE; TYPE-1; 26-WEEK; BEGIN;

D O I：

10.1016/j.diabres.2017.03.031

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: The long-acting insulin analogue degludec is a therapeutic option for patients with type 1 (T1D) or type 2 diabetes (T2D). Aim of this analysis was to investigate differences in clinical characteristics of patients before and after initiating degludec use in a cohort of German/Austrian patients. Methods: 1064 subjects with T1D/T2D and documented degludec use from the Diabetes-Patient-Follow-Up (DPV) registry were included. The follow-up cohort (n = 421) comprised patients with available data before and 3-15 months after switching to degludec. A t-test for paired values was implemented to compare rates of severe hypoglycaemia, and mean values for HbA(1C), BMI, basal insulin dose/kg bodyweight/day, and the number of basal insulin injections/day before and after switching to degludec Results were stratified by type of diabetes. In T1D, subgroup analyses were conducted (age, sex, basal insulin used before switching). P < 0.05 was considered significant. Findings: In T1D (n = 360), basal insulin dose (0.43 +/- 0.17 to 0.38 +/- 0.13 IU) and the number of basal injections/day (1.7 +/- 0.6 to 1.1 +/- 0.3) decreased whereas BMI increased from 23.2 +/- 4.8 to 24.0 +/- 5.0 kg/m(2) (all p < 0.0001) after switching to degludec. No significant changes were observed regarding rates of severe hypoglycaemia or HbA(1C)-values. Findings were comparable for subgroups. In T2D (n = 61), basal insulin dose (0.41 +/- 0.23 to 0.38 +/- 0.21; p = 0.1730) and the number of basal injections/day (1.3 +/- 0.4 to 1.1 +/- 0.3; p = 0.0097) decreased after switching to degludec. HbA(1C) improved from 7.9 +/- 1.6 to 7.1 +/- 1.5% (p < 0.0001). Conclusions: The DPV registry provides data from real-life diabetes care. Our analysis predominantly confirmed results from clinical trials and provides additional information complementing the clinical study program of degludec. (C) 2017 Elsevier B.V. All rights reserved.

引用

页码：52 / 58

页数：7

共 25 条

[1] Insulin Degludec in Type 1 Diabetes A randomized controlled trial of a new-generation ultra-long-acting insulin compared with insulin glargine [J].

Birkeland, Kare I. ;

Home, Philip D. ;

Wendisch, Ulrich ;

Ratner, Robert E. ;

Johansen, Thue ;

Endahl, Lars A. ;

Lyby, Karsten ;

Jendle, Johan H. ;

Roberts, Anthony P. ;

DeVries, J. Hans ;

Meneghini, Luigi F. .

DIABETES CARE, 2011, 34 (03) :661-665

[2] Achievement of treatment goals for secondary prevention of myocardial infarction or stroke in 29,325 patients with type 2 diabetes: a German/Austrian DPV-multicenter analysis [J].

Bohn, Barbara ;

Schoefl, Christof ;

Zimmer, Vincent ;

Hummel, Michael ;

Heise, Nikolai ;

Siegel, Erhard ;

Karges, Wolfram ;

Riedl, Michaela ;

Holl, Reinhard W. .

CARDIOVASCULAR DIABETOLOGY, 2016, 15

[3]

Childs BP, 2005, DIABETES CARE, V28, P1245

[4]

Diabetes Control and Complications Trial (DCCT)/ Epidemiology of Diabetes Interventions and Complications (EDIC) Study Research Group, 2016, INT DIAB TREATM CARD, P686

[5] Switching from twice-daily glargine or detemir to once-daily degludec improves glucose control in type 1 diabetes. An observational study [J].

Galasso, S. ;

Facchinetti, A. ;

Bonora, B. M. ;

Mariano, V. ;

Boscari, F. ;

Cipponeri, E. ;

Maran, A. ;

Avogaro, A. ;

Fadini, G. P. ;

Bruttomesso, D. .

NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES, 2016, 26 (12) :1112-1119

[6] Insulin degludec, an ultra-longacting basal insulin, versus insulin glargine in basal-bolus treatment with mealtime insulin aspart in type 2 diabetes (BEGIN Basal-Bolus Type 2): a phase 3, randomised, open-label, treat-to-target non-inferiority trial [J].

Garber, Alan J. ;

King, Allen B. ;

Del Prato, Stefano ;

Sreenan, Seamus ;

Balci, Mustafa K. ;

Munoz-Torres, Manuel ;

Rosenstock, Julio ;

Endahl, Lars A. ;

Francisco, Ann Marie Ocampo ;

Hollander, Priscilla .

LANCET, 2012, 379 (9825) :1498-1507

[7] Low-Volume Insulin Degludec 200 Units/mL Once Daily Improves Glycemic Control Similarly to Insulin Glargine With a Low Risk of Hypoglycemia in Insulin-Naive Patients With Type 2 Diabetes: A 26-week, randomized, controlled, multinational, treat-to-target trial: The BEGIN LOW VOLUME trial [J].

Gough, Stephen C. L. ;

Bhargava, Anuj ;

Jain, Rajeev ;

Mersebach, Henriette ;

Rasmussen, Soren ;

Bergenstal, Richard M. .

DIABETES CARE, 2013, 36 (09) :2536-2542

[8] Insulin degludec, an ultra-longacting basal insulin, versus insulin glargine in basal-bolus treatment with mealtime insulin aspart in type 1 diabetes (BEGIN Basal-Bolus Type 1): a phase 3, randomised, open-label, treat-to-target non-inferiority trial [J].

Heller, Simon ;

Buse, John ;

Fisher, Miles ;

Garg, Satish ;

Marre, Michel ;

Merker, Ludwig ;

Renard, Eric ;

Russell-Jones, David ;

Philotheou, Areti ;

Francisco, Ann Marie Ocampo ;

Pei, Huiling ;

Bode, Bruce .

LANCET, 2012, 379 (9825) :1489-1497

[9] Insulin Degludec/Insulin Aspart Administered Once Daily at Any Meal, With Insulin Aspart at Other Meals Versus a Standard Basal-Bolus Regimen in PatientsWith Type 1 Diabetes A 26-week, phase 3, randomized, open-label, treat-to-target trial [J].

Hirsch, Irl B. ;

Bode, Bruce ;

Courreges, Jean-Pierre ;

Dykiel, Patrik ;

Franek, Edward ;

Hermansen, Kjeld ;

King, Allen ;

Mersebach, Henriette ;

Davies, Melanie .

DIABETES CARE, 2012, 35 (11) :2174-2181

[10] International Comparison of Smoking and Metabolic Control in Patients With Type 1 Diabetes [J].

Hofer, Sabine E. ;

Miller, Kellee ;

Hermann, Julia M. ;

DeSalvo, Daniel J. ;

Riedl, Michaela ;

Hirsch, Irl B. ;

Karges, Wolfram ;

Beck, Royw. ;

Holl, ReinhardW. ;

Maahs, David M. .

DIABETES CARE, 2016, 39 (10) :E177-E178

← 1 2 3 →