Degludec hospital trial: A randomized controlled trial comparing insulin degludec U100 and glargine U100 for the inpatient management of patients with type 2 diabetes.

Autor: Galindo RJ; Division of Endocrinology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA., Pasquel FJ; Division of Endocrinology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA., Vellanki P; Division of Endocrinology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA., Alicic R; Department of Medicine, University of Washington, Seattle, Washington, USA.; Providence Health Care, Spokane, Washington, USA., Lam DW; Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA., Fayfman M; Division of Endocrinology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA., Migdal AL; Division of Endocrinology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA., Davis GM; Division of Endocrinology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA., Cardona S; Division of Endocrinology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA., Urrutia MA; Division of Endocrinology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA., Perez-Guzman C; Division of Endocrinology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA., Zamudio-Coronado KW; Division of Endocrinology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA., Peng L; Department of Biostatistics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA., Tuttle KR; Providence Health Care, Spokane, Washington, USA.; Division of Nephrology and Kidney Research Institute, Department of Medicine, University of Washington, Seattle, Washington, USA., Umpierrez GE
Jazyk: angličtina
Zdroj: Diabetes, obesity & metabolism [Diabetes Obes Metab] 2022 Jan; Vol. 24 (1), pp. 42-49. Date of Electronic Publication: 2021 Sep 24.
DOI: 10.1111/dom.14544
Abstrakt: Aims: Limited data exist about the use of insulin degludec in the hospital. This multicentre, non-inferiority, open-label, prospective randomized trial compared the safety and efficacy of insulin degludec-U100 and glargine-U100 for the management of hospitalized patients with type 2 diabetes.
Methods: In total, 180 general medical and surgical patients with an admission blood glucose (BG) between 7.8 and 22.2 mmol/L, treated with oral agents or insulin before hospitalization were randomly allocated (1:1) to a basal-bolus regimen using degludec (n = 92) or glargine (n = 88), as basal and aspart before meals. Insulin dose was adjusted daily to a target BG between 3.9 and 10.0 mmol/L. The primary endpoint was the difference in mean hospital daily BG between groups.
Results: Overall, the randomization BG was 12.2 ± 2.9 mmol/L and glycated haemoglobin 84 mmol/mol (9.8% ± 2.0%). There were no differences in mean daily BG (10.0 ± 2.1 vs. 10.0 ± 2.5 mmol/L, p = .9), proportion of BG in target range (54·5% ± 29% vs. 55·3% ± 28%, p = .85), basal insulin (29.6 ± 13 vs. 30.4 ± 18 units/day, p = .85), length of stay [median (IQR): 6.7 (4.7-10.5) vs. 7.5 (4.7-11.6) days, p = .61], hospital complications (23% vs. 23%, p = .95) between treatment groups. There were no differences in the proportion of patients with BG <3.9 mmol/L (17% vs. 19%, p = .75) or <3.0 mmol/L (3.7% vs. 1.3%, p = .62) between degludec and glargine.
Conclusion: Hospital treatment with degludec-U100 or glargine-U100 is equally safe and effective for the management of hyperglycaemia in general medical and surgical patients with type 2 diabetes.
(© 2021 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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