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Switching to Once-Daily Insulin Degludec/Insulin Aspart from Basal Insulin Improves Postprandial Glycemia in Patients with Type 2 Diabetes Mellitus : Randomized Controlled Trial

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Title: Switching to Once-Daily Insulin Degludec/Insulin Aspart from Basal Insulin Improves Postprandial Glycemia in Patients with Type 2 Diabetes Mellitus : Randomized Controlled Trial
Authors: Cho, Kyu Yong Browse this author
Nakamura, Akinobu Browse this author →KAKEN DB
Oba-Yamamoto, Chiho Browse this author
Tsuchida, Kazuhisa Browse this author
Yanagiya, Shingo Browse this author
Manda, Naoki Browse this author
Kurihara, Yoshio Browse this author
Aoki, Shin Browse this author
Atsumi, Tatsuya Browse this author →KAKEN DB
Miyoshi, Hideaki Browse this author →KAKEN DB
Keywords: Diabetes mellitus, type 2
Hypoglycemia
Insulin degludec
Insulin degludec, insulin aspart drug combination
Randomized controlled trial
Issue Date: 2019
Publisher: Korean Diabetes Association
Journal Title: Diabetes & Metabolism Journal
Volume: 43
Start Page: e66
Publisher DOI: 10.4093/dmj.2019.0093
Abstract: Background: To explore the efficacy and safety of switching from once-daily basal insulin therapy to once-daily pre-meal injection insulin degludec/insulin aspart (IDegAsp) with respect to the glycemic control of participants with type 2 diabetes mellitus (T2DM). Methods: In this multicenter, open-label, prospective, randomized, parallel-group comparison trial, participants on basal insulin therapy were switched to IDegAsp (IDegAsp group; n=30) or continued basal insulin (Basal group; n=29). The primary endpoint was the superiority of IDegAsp in causing changes in the daily blood glucose profile, especially post-prandial blood glucose concentration after 12 weeks. Results: Blood glucose concentrations after dinner and before bedtime were lower in the IDegAsp group, and the improvement in blood glucose before bedtime was significantly greater in the IDegAsp group than in the Basal group at 12 weeks (−1.7±3.0 mmol/L vs. 0.3±2.1 mmol/L, P<0.05). Intriguingly, glycemic control after breakfast was not improved by IDegAsp injection before breakfast, in contrast to the favorable effect of injection before dinner on blood glucose after dinner. Glycosylated hemoglobin significantly decreased only in the IDegAsp group (58 to 55 mmol/mol, P<0.05). Changes in daily insulin dose, body mass, and recorded adverse effects, including hypoglycemia, were comparable between groups. Conclusion: IDegAsp was more effective than basal insulin at reducing blood glucose after dinner and before bedtime, but did not increase the incidence of hypoglycemia. Switching from basal insulin to IDegAsp does not increase the burden on the patient and positively impacts glycemic control in patients with T2DM.
Rights: http://creativecommons.org/licenses/by-nc/4.0/
Type: article
URI: http://hdl.handle.net/2115/78817
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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