Asheville, NC—Hypoglycemia, common in patients with type 1 diabetes and a relatively routine issue for those with type 2 diabetes, is a dangerous condition that makes it difficult to achieve good glycemic control.
That’s according to two recent studies published in JAMA looking at which types of insulin are less likely to drive down blood sugar to risky levels.
The research determined that treatment with the insulin degludec compared with insulin glargine U100 for 32 weeks resulted in a reduced rate of hypoglycemic episodes among patients with type 1 or 2 diabetes and at least one risk factor for hypoglycemia.
In one study, researchers from Mountain Diabetes and Endocrine Center in Asheville, North Carolina, and colleagues randomly assigned 501 adults with type 1 diabetes and at least one hypoglycemia risk factor to receive once-daily insulin degludec, followed by insulin glargine U100, or to receive insulin glargine U100 followed by insulin degludec for two 32-week treatment periods.
Results indicate that insulin degludec compared with insulin glargine U100 resulted in lower rates of overall symptomatic hypoglycemic episodes and nocturnal symptomatic hypoglycemia in the 16-week maintenance period. In addition, a lower percentage of patients experienced severe hypoglycemia during the maintenance period—10% versus 17%.
Study authors suggest that their higher-than-expected withdrawal rate might have been caused by the nature of the trial, which lasted 64 weeks, offered two different treatments, and required use of a vial and a syringe.
The second study was led by researchers at the University of Washington School of Medicine, Spokane, and involved 721 adults with type 2 diabetes and at least one hypoglycemia risk factor. The patients, who were previously treated with basal insulin with or without oral antidiabetic drugs, were randomized to receive once-daily insulin degludec followed by insulin glargine U100 or to receive insulin glargine U100 followed by insulin degludec for two 32-week treatment periods.
Results suggest that treatment with insulin degludec compared with insulin glargine U100 resulted in a statistically significant and clinically meaningful reduction in the rate of overall symptomatic hypoglycemia and nocturnal symptomatic hypoglycemia during the 16-week maintenance period.
Study authors point out that the hypoglycemia findings were consistent when analyzed over the full treatment period and continued to show a significantly lower rate of severe hypoglycemia with insulin degludec.
In that trial, 1.6% of patients on insulin degludec experienced severe hypoglycemia during the maintenance period compared with 2.4% for insulin glargine U100.
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