Endocrine Abstracts

Introduction: Insulin degludec (IDeg) is a new-generation insulin that forms soluble multi-hexamers after s.c. injection, resulting in ultra-long duration of action.

Objective: We investigated the efficacy of glycemic control and safety on Japanese patients with type 2 diabetes who treated temporarily with IDeg or glargine and achieved target glucose level.

Research design and methods: Ten Japanese subjects with type 2 diabetes (male/female; 8/2, Age; 59.8±12.1 years, disease duration; 3.9±4.2 years, HbA1c; 9.0±2.4%, BMI; 26.7±3.7, FPG; 179±49 mg/dl, 2hPPG; 291±123 mg/dl, FCPR; 2.3±1.3 ng/ml) were treated with a short-term, 3–4 week course of IDeg to achieve a target 2hPPG of <140 mg/dl without oral medication in admission. They were initially treated with 4 unit of IDeg and titrated according to the treat-to-target protocol. Efficacy and safety of short-term IDeg therapy were retrospectively compared with conventional basal insulin glargine therapy. Glycemic control after withdrawal of IDeg or glargine was also followed up.

Results: FPG of IDeg-treated group decreased to <100 mg/dl in 8.8±2.2 days and remained in a flat and stable range. Maximum dose of IDeg to achieve target blood glucose level was 23.0±4.8 unit/day on average. Blood glucose levels of IDeg-withdrawn patients were kept without medication or with only oral antidiabetic drugs. Hypoglycemic episodes were observed 3 times in a patient treated with IDeg, which were due to inappropriate exercise before meal. Treat-to-target protocol of IDeg provided prompt and fine glycemic control. Body weight was decreased by 2 kg on average with temporary IDeg therapy.

Conclusion: Short-term, temporary basal insulin IDeg therapy improved glycemic control in Japanese patients with T2DM.