Abstract

Switching from insulin glargine to insulin degludec: Safety and efficacy in Colombian adolescents with type 1 diabetes

Author(s): Myrey Siuffi D*

Introduction: Degludec (Ideg) is an ultra-long acting insulin, with a more stable pharmacodynamic profile than other commonly used insulin analogues. The effect of Ideg has not been adequately evaluated in real-world conditions for the management of adolescent patients with type 1 diabetes (DM1). Methods: A prospective, before-and-after study was conducted including adolescent DM1 patients managed on an outpatient basis at the endocrinology unit of the Clínica Farallones in Cali, Colombia. The impact of switching from a Glargine insulin to a basal insulin regimen with Ideg for a year on glycated hemoglobin (HbA1c) levels, the frequency of hospitalizations for diabetic ketoacidosis and frequency of episodes of hypoglycaemia were evaluated on a quarterly basis. Results: 15 patients 13.6 +/- 1.5 years old were recruited. There was a reduction in HbA1c levels of -1.46% (95% CI -0.77, -2.15, p=0.0004) 12 months after switching to Ideg. The percentage of patients presenting at least one episode of hypoglycaemia <54 mg/dL decreased from 80% to 0% (p<0.001). The rate of hospitalizations decreased from 2.4 +/- 1.8 to 1.4 +/- 0.83 events (p<0.01); such findings are retained in the subgroup of patients with occasional forgetfulness in insulin administration and poor adherence to strict glucose self-monitoring recommendations. Conclusions: Our results suggest that Ideg treatment significantly reduces episodes of hypoglycaemia and diabetic ketoacidosis hospitalizations, besides improving metabolic control in adolescents with DM1.