Impact of Switching from Twice-Daily Basal Insulin to Once-Daily Insulin Glargine 300 U/mL (Gla-300) in Patients with Type 1 Diabetes (T1DM)—Phase 4 OPTIMIZE Study, Belgian Cohort

The 26-year-old woman was diagnosed with type 1 diabetes in 2014. The diagnosis was confirmed while there was a slight increase in blood glucose and HbA1c levels using oral glucose tolerance test, determination of insulin levels and GADA testing. This was followed by a 2-year period with complete remissions and partial remissions of 2-8 U daily basal insulin glargine. Thereafter, the patient became pregnant. The minimal basal insulin used to date has been switched to human rapid-acting and NPH insulins five times daily, which had to be increased to 11 times the initial dose in the third trimester of pregnancy. After a successful spontaneous birth of a healthy baby girl, our patient wished to return to one-tenth of the maximum insulin dose that was used during pregnancy, to once daily insulin glargine. After three months, her blood glucose levels began to rise, with oral glucose challenge test showing a marked increase in blood glucose and a drastic reduction in C-peptide levels. This was when we switched to multiple daily insulin administration using glargine basal- and glulisine analogue insulins. Later, glargine was switched to insulin degludec, and with a 30-33 U total daily insulin dose and CGM for the past two years, the patient was in a satisfactory metabolic state.

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ONCE-DAILY INSULIN GLARGINE COMPARED WITH TWICE-DAILY NPH INSULIN IN PATIENTS WITH TYPE 1 DIABETES

Endocrine Practice ◽

10.4158/ep.10.1.10 ◽

2004 ◽

Vol 10 (1) ◽

pp. 10-17 ◽

Cited By ~ 17

Author(s):

Kenneth S. Hershon ◽

Thomas C. Blevins ◽

Thomas C. Blevins

Keyword(s):

Type 1 Diabetes ◽

Insulin Glargine ◽

Nph Insulin ◽

Once Daily ◽

Daily Insulin

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Comparative Efficacy of Once Daily Insulin Glargine with Twice Daily NPH Insulin in Children with Type 1 Diabetes

Journal of Diabetes & Metabolism ◽

10.4172/2155-6156.1000124 ◽

2011 ◽

Vol 02 (03) ◽

Author(s):

Arushi Saini ◽

Devidayal . ◽

Savita Verma ◽

AK Bhalla

Keyword(s):

Type 1 Diabetes ◽

Insulin Glargine ◽

Comparative Efficacy ◽

Nph Insulin ◽

Once Daily ◽

Daily Insulin

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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

International Journal of Endocrinology ◽

10.1155/2015/176261 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6 ◽

Cited By ~ 8

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.

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