Insulin degludec has lower rates of nocturnal hypoglycaemia in T1D compared to insulin glargine: Study

Nocturnal hypoglycemia is a serious complication of insulin-treated diabetes, which commonly goes undetected. 

Patients with T1D  have lower rates of nocturnal symptomatic hypoglycaemia and all-day severe hypoglycaemia with insulin degludec as compared with insulin glargine U100, finds a new study

The findings of the study are published in Diabetes,Obesity and Metabolism journal.

The objective of the study was to investigate whether insulin degludec compared with insulin glargine U100 reduces the risk of nocturnal and severe hypoglycaemia in patients prone to nocturnal severe hypoglycaemia.

The researchers conducted a randomized, controlled, open-label cross-over trial and compared the frequency of symptomatic hypoglycemia on insulin degludec versus insulin glargine in 149 patients with T1D who had at least one episode of severe nocturnal hypoglycemia within the last 2 years.

The study was two-year prospective, randomised, open, multicentre, cross-over trial. A total of 149 patients were randomised 1:1 to basal-bolus therapy with insulin degludec and insulin aspart or insulin glargine U100 and insulin aspart. The primary endpoint was the number of blindly adjudicated nocturnal symptomatic hypoglycaemic episodes. Secondary endpoints included the occurrence of severe hypoglycaemia. We analysed all endpoints by intention-to-treat.

It was found that those on insulin degludec experienced less nocturnal hypoglycemia, with a relative rate reduction of 28% for glucose less than 70 and 37% for glucose less than 54. No difference in daytime hyperglycemia between insulin glargine- and insulin degludec-treated patients was observed.

The results of the study were

• Treatment with insulin degludec resulted in a 28% (95%CI: 9-43; p=0.02) relative rate reduction (RRR) of nocturnal symptomatic hypoglycaemia at level 1 (≤3.9 mmol/L).

• A 37% (95%CI: 16-53; p=0.002) RRR at level 2 (≤3.0 mmol/l), and a 35% (95%CI: 1-58; p=0.04) RRR in all-day severe hypoglycaemia compared to insulin glargine U100 was found.

The data suggests that insulin degludec use reduces nocturnal hypoglycemia.

Bjergaard and team concluded that  patients with T1D are prone to nocturnal severe hypoglycaemia and have lower rates of nocturnal symptomatic hypoglycaemia and all-day severe hypoglycaemia with insulin degludec as compared with insulin glargine U100.

Reference: https://doi.org/10.1111/dom.14574