The Effect of Insulin Degludec Versus Insulin Glargine U100 on Glucose Metrics Recorded During Continuous Glucose Monitoring in People With Type 1 Diabetes and Recurrent Nocturnal Severe Hypoglycemia

Brøsen, JMB; Agesen, RM; Alibegovic, AC; Andersen, HU; Beck-Nielsen, H; Gustenhoff, P; Hansen, TK; Hedetoft, C; Jensen, TJ; Juhl, CB; Stolberg, CR; Lerche, SS; Nørgaard, K; Parving, HH; Tarnow, L; Thorsteinsson, B; Pedersen-Bjergaard, U

doi:10.1177/19322968231197423

Type 1 diabetes

The Effect of Insulin Degludec Versus Insulin Glargine U100 on Glucose Metrics Recorded During Continuous Glucose Monitoring in People With Type 1 Diabetes and Recurrent Nocturnal Severe Hypoglycemia

J Diabetes Sci TechnolPublished 6 Sep 2023Randomised controlled trial

Primary result · TIR (70-180 mg/dL)ResultEstimated treatment difference −4.6 % 95% CI −9.1 to −0.0

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Authors' conclusion

For people with T1D suffering from recurrent nocturnal severe hypoglycemia, treatment with IDeg, compared with IGlar-100, results in a lower TBR and CV during the night at the expense of more TAR.

Study context

Population: Adults with T1D and ≥1 episode of nocturnal severe hypoglycemia within the last two years74 analysed
Participants: 149 adults

Comparison: Insulin degludec vs insulin glargine U100
Primary endpoint: CGM-recorded metrics: TIR, time-below-range (TBR), time-above-range (TAR) and coefficient of variation (CV)

Methodological detailsmulticenter, crossover, two-year, Six days of blinded continuous glucose monitoring (CGM) offered twice during each treatment

Multicenter
Crossover
Two-year
Six days of blinded CGM offered twice during each treatment

Primary result

TIR (70-180 mg/dL) · night (23:00-06:59)

Estimated treatment difference

−4.6 %

95% CI −9.1 to −0.0

P = 0.049

By group

IDeg49.0%

IGlar-10054.0%

IDegvs IGlar-100

estimated treatment difference −4.6 % (95% CI −9.1 to −0.0); P = 0.049

As reported in the abstract

Further findings

Outcome	← Lower with IDeg ←→ Higher with IDeg →	Estimated treatment difference (%) (95% CI)	P value
TBR level 1 (54-69 mg/dL) · night	−10−50510	−1.7 (−2.9 to −0.5)	P < 0.05
TBR level 2 (<54 mg/dL) · night	−10−50510	−1.3 (−2.1 to −0.5)	P = 0.001
TAR level 1 (181-250 mg/dL) · night	−10−50510	4.0 (0.8–7.3)	P < 0.05
TAR level 2 (> 250 mg/dL) · night	−10−50510	4.0 (0.8–7.2)	P < 0.05
Mean CV · night	−10−50510	−3.4 (−5.6 to −1.2)	P < 0.05
	−10−50510Difference, % (linear scale)

Original publication

The Effect of Insulin Degludec Versus Insulin Glargine U100 on Glucose Metrics Recorded During Continuous Glucose Monitoring in People With Type 1 Diabetes and Recurrent Nocturnal Severe Hypoglycemia. J Diabetes Sci Technol. Published 6 September 2023. doi:10.1177/19322968231197423

Read the original article ↗

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