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[Basal insulin degludec (Tresiba®)].

A J Scheen1, C Mathieu2

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Summary

Insulin degludec offers a prolonged glucose-lowering effect for diabetes management. Clinical trials show it reduces nocturnal hypoglycemia compared to insulin glargine U100 in type 1 and type 2 diabetes patients.

Keywords:
Insulin degludecInsulin glargineType 1 diabetesType 2 diabetesBasal insulin

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Area of Science:

  • Endocrinology
  • Pharmacology
  • Metabolic Diseases

Background:

  • Insulin degludec is a novel ultra-long-acting basal insulin analog.
  • It provides a continuous and prolonged pharmacokinetic and pharmacodynamic profile post-subcutaneous injection.
  • Understanding its comparative efficacy and safety is crucial for diabetes treatment.

Purpose of the Study:

  • To assess the efficacy and safety of insulin degludec compared to insulin glargine U100.
  • To evaluate the reduction in hypoglycemic episodes, particularly nocturnal ones.
  • To confirm clinical benefits across various patient populations and real-world settings.

Main Methods:

  • Phase 3 clinical trials (BEGIN program) comparing insulin degludec with insulin glargine U100.
  • Complementary studies (SWITCH program) in high-risk patients.
  • Cardiovascular outcome trial (DEVOTE) and observational studies (EU-TREAT).

Main Results:

  • Similar glycemic control (HbA1c reduction) was achieved with both insulins.
  • Insulin degludec demonstrated a significant reduction in nocturnal hypoglycemic episodes compared to insulin glargine U100.
  • Benefits were consistent across type 1 and type 2 diabetes patients, including those at high cardiovascular or hypoglycemia risk.

Conclusions:

  • Insulin degludec provides comparable glycemic control to insulin glargine U100 with a lower risk of nocturnal hypoglycemia.
  • Its prolonged action and improved reproducibility offer a clinical advantage.
  • Insulin degludec is indicated for type 1 and type 2 diabetes, offering flexible treatment options.