scholarly journals Switching from Twice-Daily Basal Insulin Injections to Once-Daily Insulin Degludec Injection for Basal-Bolus Insulin Regimen in Japanese Patients with Type 1 Diabetes: A Pilot Study

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Yuka Tosaka ◽  
Akio Kanazawa ◽  
Fuki Ikeda ◽  
Mayu Iida ◽  
Junko Sato ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Basal Insulin ◽  
Japanese Patients ◽  
Insulin Degludec ◽  
Insulin Regimen ◽  
Once Daily ◽  
Daily Insulin ◽  
Bolus Insulin ◽  
Basal Bolus

The aim of this study was to investigate the efficacy of insulin degludec used for basal-bolus insulin regimen after switching from twice-daily basal insulin in Japanese patients with type 1 diabetes mellitus. The subjects were 22 type 1 diabetes patients treated with basal-bolus insulin regimen with twice-daily basal insulin. Basal insulin was switched to once-daily injection of insulin degludec with 10% dose reduction. HbA1c and fasting plasma glucose (FPG) were measured before and 12 weeks after switching. The frequency of hypoglycemic episodes, standard deviation (SD) of blood glucose, and mean of daily difference (MODD) were evaluated by continuous glucose monitoring (CGM) before and 4 weeks after switching. HbA1c and FPG before and 12 weeks after switching were comparable (HbA1c 8.5 ± 1.4 versus 8.7 ± 1.6%,P=0.28; FPG 203.2 ± 81.2 versus 206.5 ± 122.4 mg/dL,P=0.91). The frequency of hypoglycemia during nighttime was not significantly different at 4 weeks after switching (14.4 ± 17.0 versus 11.1 ± 15.0%,P=0.45). In addition, SD and MODD before and 4 weeks after switching were also comparable. In conclusion, glycemic control under once-daily insulin degludec injection was almost comparable to that under twice-daily basal insulin injections in Japanese type 1 diabetes patients. This study was registered with ID:UMIN000010474.

scholarly journals Feasibility of Simplification From a Basal-Bolus Insulin Regimen to a Fixed-Ratio Formulation of Basal Insulin Plus a GLP-1RA or to Basal Insulin Plus an SGLT2 Inhibitor: BEYOND, a Randomized, Pragmatic Trial

2021 ◽  
Author(s):  
Dario Giugliano ◽  
Miriam Longo ◽  
Paola Caruso ◽  
Rosa Di Fraia ◽  
Lorenzo Scappaticcio ◽  
...  
Keyword(s):  
Basal Insulin ◽  
Insulin Dose ◽  
Pragmatic Trial ◽  
Sglt2 Inhibitor ◽  
Fixed Ratio ◽  
Insulin Regimen ◽  
Similar Reduction ◽  
Once Daily ◽  
Bolus Insulin ◽  
Basal Bolus

<b>OBJECTIVE </b> <p><b>BEYOND trial evaluated the feasibility of either basal insulin + GLP-1RA (glucagon-like peptide-1 receptor agonist), or basal insulin + SGLT-2i (sodium-glucose cotransporter-2 inhibitor) to replace a full basal-bolus insulin (BBI) regimen in participants with type 2 diabetes and</b><b> </b><b>inadequate glycemic control. </b></p> <p><b>RESEARCH DESIGN AND METHODS</b> </p> <p><b>Participants were randomized (1:1:1) to: a) intensification of the BBI regimen (n = 101), b) fixed-ratio of basal insulin + GLP-1RA (fixed-combo group, n = 102), and c) combination of basal insulin + SGLT-2i (gliflo-combo group, n = 102). The primary efficacy outcome was change from baseline in HbA1c at 6 months. </b><b></b></p> <p><b>RESULTS</b></p> <p><b>Baseline characteristics were similar among the 3 groups (mean HbA1c was 8.6%, 70 mmol/mol). At 6 months, patients experienced similar reduction in HbA1c level (-0.6 ± 0.8, -0.6 ± 0.8, -0.7 ± 0.9%, mean ± SD, respectively, noninferiority P < 0.001 vs BBI) and the proportion of patients with HbA1c ≤7.5% was also similar (34%, 28% and 27%, respectively, P = 0.489). Total insulin dose increased in BBI group (62 U/day), and decreased both in the fixed-combo and gliflo-combo groups (27 U and 21 U/day, respectively, P <0.01</b><b>). The proportion of patients with hypoglycemia was 17.8%, 7.8% and 5.9%, respectively (P = 0.015). There were 12 drop-outs in the fixed-combo group, 9 in the gliflo-combo group and none in the BBI group. </b><b></b></p> <p><b>CONCLUSIONS</b> </p> <p><b>BEYOND provides evidence that it is possible and safe to switch from a BBI regimen to either a once daily fixed-combo injection or once daily gliflozin added to basal insulin, with similar glucose control, less insulin doses, less injections daily, and less hypoglycemia.</b><b></b></p>

1105-P: Impact of Switching from Twice-Daily Basal Insulin (BI) to Once-Daily Insulin Glargine 300 U/mL (Gla-300) in Patients with Type 1 Diabetes (T1DM): Phase 4 Optimize Study

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 1105-P
Author(s):  
CHANTAL MATHIEU ◽  
PETER STELLA ◽  
JACQUES BRUHWYLER ◽  
KATHY C. ALEXANDRE
Keyword(s):  
Type 1 Diabetes ◽  
Insulin Glargine ◽  
Basal Insulin ◽  
Once Daily ◽  
Daily Insulin

scholarly journals A novel approach to basal-bolus insulin initiation in adults with newly diagnosed type 1 diabetes: an observational cohort study of a service redesign

2018 ◽  
Vol 18 (2) ◽  
pp. 71-75
Author(s):  
Helen E Hopkinson ◽  
Anna D White ◽  
Peter Nightingale ◽  
Parth Narendran
Keyword(s):  
Type 1 Diabetes ◽  
Glycaemic Control ◽  
Basal Insulin ◽  
Dose Adjustment ◽  
Newly Diagnosed ◽  
Insulin Initiation ◽  
Carbohydrate Counting ◽  
Bolus Insulin ◽  
Basal Bolus

Aims: The National Institute for Health and Care Excellence (NICE) recommendation for insulin in newly diagnosed type 1 diabetes is a ‘basal-bolus’ regimen of prandial insulin with twice-daily basal insulin initiated at diagnosis. We developed an insulin initiation programme that embraces the contribution of endogenous insulin to glycaemic control in adults newly diagnosed with type 1 diabetes. Our aim was to embed carbohydrate counting skills and dose adjustment very early on to mitigate against the decline in glycaemic control that is commonly seen post honeymoon.Methods: We designed a novel insulin initiation programme that focused initially on prandial insulin replacement using the lowest possible dose of basal insulin. The approach also facilitates carbohydrate counting and bolus insulin dose adjustment behaviours from diagnosis.Results: Prior to implementing the new programme, the mean HbA1c at 12 months was 64 mmol/mol (8.0%) (95% CI 60 to 69 (7.6% to 8.4%)). This reduced to 55 mmol/mol (7.1%) (95% CI 51 to 58 (6.9% to 7.4%)), p<0.001 with the new programme. The improved HbA1c persisted to 3 years of follow-up (p<0.001). There were no episodes of diabetic ketoacidosis or severe hypoglycaemia associated with this novel approach.Conclusions: We suggest that using minimal basal insulin and focusing on prandial bolus insulin replacement in adults newly diagnosed with type 1 diabetes is safe, more physiological and may be better able to achieve lasting glycaemic control than the currently proposed national guidelines. This approach will need to be tested formally in an adequately designed randomised controlled clinical trial.

Basal and Bolus Insulin Dose Changes after Switching Basal Insulin to Insulin Degludec in Patients with Type 1 Diabetes Mellitus: A Pilot Study

2017 ◽  
Vol 37 (9) ◽  
pp. 845-852 ◽  
Author(s):  
Yoshiyuki Hamamoto ◽  
Sachiko Honjo ◽  
Kanta Fujimoto ◽  
Shinsuke Tokumoto ◽  
Hiroki Ikeda ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Pilot Study ◽  
Type 1 Diabetes Mellitus ◽  
Basal Insulin ◽  
Insulin Dose ◽  
Insulin Degludec ◽  
Bolus Insulin
Sign in / Sign up

Export Citation Format

Share Document