Long-term management of type 2 diabetes with faster aspart, degludec and flash glucose monitoring

Author(s): Bologna Carolina1*, Lugarà Marina1 & Naddeo Mariella2

Objective: To evaluate the clinical and prognostic impact of innovative therapies in hospitalized patients with poorly controlled type 2 diabetes (T2D).

Methods: Longitudinal, prospective study with a 6-month follow-up, involving patients with T2D admitted to an Internal Medicine ward for any reason. All patients, upon hospital admission, were treated with second generation rapid and basal insulins (faster apart and degludec). Flash glucose monitoring (FGM) through the Libre Free Style was used instead of self-monitoring of blood glucose through the glucometers. After hospital admission, patients continued the same approach and were evaluated after 6 months.

Results: Overall, 34 consecutive eligible patients were included in the study in the period between March 2019 and March 2021. Mean age was 67.2 ± 5.8 years and 73.3% were men. Of note, 12 out of 34 patients (35.3%) had been admitted for COVID-19. After six months from admission, a mean reduction of HbA1c levels of 1.3 ± 0.7% was documented. Fasting blood glucose levels, obesity indices, renal and liver function also significantly improved. Episodes of mild hypoglycemia occurred in 10 (29.4%) patients, while no severe episodes were reported. A highly statistically significant improvement was also found in the overall EQ-5D Index value and VAS score, suggesting a possible cost-effective profile of this approach.

Conclusion: The study represents an important proof-of-concept that also inpatients, a category usually not included among those eligible for innovative therapeutic options, can benefit of second generation insulin’s and FGM from a clinical and economic viewpoint.