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Henao-Carrillo DC, Muñoz OM, Gómez AM, et al. Reduction of glycemic variability with Degludec insulin in patients with unstable diabetes. J Clin Transl Endocrinol. 2018;12:8-12doi: 10.1016/j.jcte.2018.03.003.
Henao-Carrillo, D. C., Muñoz, O. M., Gómez, A. M., Rondón, M., Colón, C., Chica, L., Rubio, C., León-Vargas, F., Calvachi, M. A., & Perea, A. M. (2018). Reduction of glycemic variability with Degludec insulin in patients with unstable diabetes. Journal of clinical & translational endocrinology, 128-12. https://doi.org/10.1016/j.jcte.2018.03.003
Henao-Carrillo, Diana Cristina, et al. "Reduction of glycemic variability with Degludec insulin in patients with unstable diabetes." Journal of clinical & translational endocrinology vol. 12 (2018): 8-12. doi: https://doi.org/10.1016/j.jcte.2018.03.003
Henao-Carrillo DC, Muñoz OM, Gómez AM, Rondón M, Colón C, Chica L, Rubio C, León-Vargas F, Calvachi MA, Perea AM. Reduction of glycemic variability with Degludec insulin in patients with unstable diabetes. J Clin Transl Endocrinol. 2018 Mar 26;12:8-12. doi: 10.1016/j.jcte.2018.03.003. eCollection 2018 Jun. PMID: 29892561; PMCID: PMC5992319.
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J Clin Transl Endocrinol. 2018 Mar 26;12:8-12. doi: 10.1016/j.jcte.2018.03.003. eCollection 2018 Jun.

Reduction of glycemic variability with Degludec insulin in patients with unstable diabetes.

Journal of clinical & translational endocrinology

Diana Cristina Henao-Carrillo, Oscar M Muñoz, Ana M Gómez, Martín Rondón, Christian Colón, L Chica, Claudia Rubio, Fabián León-Vargas, Maria Alejandra Calvachi, Ana María Perea

Affiliations

  1. Pontificia Universidad Javeriana, Bogotá, Colombia.
  2. Hospital Universitario San Ignacio, Bogotá, Colombia.
  3. Centro de Excelencia para el manejo de la diabetes (CEMDI), Colombia.
  4. Universidad Antonio Nariño, Bogotá, Colombia.

PMID: 29892561 PMCID: PMC5992319 DOI: 10.1016/j.jcte.2018.03.003

Abstract

INTRODUCTION: Degludec (IDeg) is an ultralong-acting insulin, with stable pharmacodynamic profile which leads to lower fluctuations in glucose levels. The effect of IDeg has not been specifically assessed in patients with unstable diabetes, defined as increased glycemic variability (GV).

METHODS: A prospective before-after pilot study was conducted, including patients managed at Hospital Universitario San Ignacio in Bogotá, Colombia. The impact of the switch from a Glargine or Detemir insulin to a basal insulin regimen with IDeg for 12 weeks on GV measured by continuous glucose monitoring, on A1c levels, and on the incidence of episodes of global and nocturnal hypoglycemia was assessed in a group of patients with (coefficient of variation >34%) or without increased basal GV using a Generalised Estimating Equation (GEE) analysis.

RESULTS: 60 patients with basal bolus therapy and history of hypoglycemia were included. 18 patients had High GV (HGV). In this group a significant reduction of 11.1% of CV (95% CI: 6.3, 15.9, p = 0.01) was found. GEE analysis confirmed a higher impact over time on patients with HGV (p < 0.001). The percentage of patients with at least 1 episode of hypoglycemia decreased from 66.6% to 22.2% (p = 0.02) and from 37.14% to 5.71% (p < 0.01) for global and nocturnal hypoglycemia, respectively. Changes were not significant in patients with low GV. A reduction of A1c was observed in both groups (p < 0.001).

CONCLUSIONS: The results suggest that treatment with IDeg reduces GV, A1c levels and the incidence of global and nocturnal hypoglycemia events in patients with HGV, but not in patients with low GV.

Keywords: A1c, Glycated hemoglobin; BMI, Body mass index; CGM, Continuos glucose monitoring; CONGA, continuous overall net glycemic action; CV, coefficient of variation; DM1, Type 1 diabetes; DM2, Type 2 diabetes; Glycemic variability; HGV, High glycemic variability; IDeg, Insulin degludec; IQR, interquartile range; Insulin degludec; LBGI, low blood glucose index; LGV, low glycemic variability; MAG, mean absolute glucose change; MAGE, mean amplitude of glucose excursion; MOOD, mean of daily difference; SD, Standard deviation; TDD, total daily insulin dose; Type 1 diabetes; Type 2 diabetes; UD, Unstable diabetes

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