In:
Journal of Diabetes Science and Technology, SAGE Publications
Abstract:
Comparing continuous glucose monitoring (CGM)-recorded metrics during treatment with insulin degludec (IDeg) versus insulin glargine U100 (IGlar-100) in people with type 1 diabetes (T1D) and recurrent nocturnal severe hypoglycemia. Materials and methods: This is a multicenter, two-year, randomized, crossover trial, including 149 adults with T1D and minimum one episode of nocturnal severe hypoglycemia within the last two years. Participants were randomized 1:1 to treatment with IDeg or IGlar-100 and given the option of six days of blinded CGM twice during each treatment. CGM traces were reviewed for the percentage of time-within-target glucose range (TIR), time-below-range (TBR), time-above-range (TAR), and coefficient of variation (CV). Results: Seventy-four participants were included in the analysis. Differences between treatments were greatest during the night (23:00-06:59). Treatment with IGlar-100 resulted in 54.0% vs 49.0% with IDeg TIR (70-180 mg/dL) (estimated treatment difference [ETD]: –4.6%, 95% confidence interval [CI] : –9.1, –0.0, P = .049). TBR was lower with IDeg at level 1 (54-69 mg/dL) (ETD: –1.7% [95% CI: –2.9, –0.5], P 〈 .05) and level 2 ( 〈 54 mg/dL) (ETD: –1.3% [95% CI: –2.1, –0.5], P = .001). TAR was higher with IDeg compared with IGlar-100 at level 1 (181-250 mg/dL) (ETD: 4.0% [95% CI: 0.8, 7.3] , P 〈 .05) and level 2 ( 〉 250 mg/dL) (ETD: 4.0% [95% CI: 0.8, 7.2], P 〈 .05). The mean CV was lower with IDeg than that with IGlar-100 (ETD: –3.4% [95% CI: –5.6, –1.2], P 〈 .05). Conclusion: For people with T1D suffering from recurrent nocturnal severe hypoglycemia, treatment with IDeg, compared with IGlar-100, results in a lower TBR and CV during the night at the expense of more TAR.
Type of Medium:
Online Resource
ISSN:
1932-2968
,
1932-2968
DOI:
10.1177/19322968231197423
Language:
English
Publisher:
SAGE Publications
Publication Date:
2023
detail.hit.zdb_id:
2467312-2
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