A pilot study comparing the CGM-assessed glycemic profiles of patients with type 1 diabetes on insulin degludec and insulin glargine
Authors: Kuroda, Akio; Tsuruo, Miho; Aki, Nanako; Kondo, Takeshi; Oguro, Yukari; Tamaki, Motoyuki; Aihara, Ken-ichi; Endo, Itsuro; Matsumoto, Toshio; Abe, Masahiro; Matsuhisa, Munehide
Aims To compare the diurnal glycemic profiles obtained with basal insulin degludec (InsDeg) and basal insulin glargine (InsGla) in patients with type 1 diabetes using continuous glucose monitoring (CGM) in an outpatient setting. Methods Twenty Japanese patients with type 1 diabetes who were using oncedaily InsGla before supper as part of their multiple daily insulin injections were consecutively recruited. CGM was initiated before supper on day 1, and InsGla was switched to InsDeg at the same dose on day 3. The average CGM glucose profile obtained on days 1 and 2 was compared with the corresponding profile for days 5 and 6. The bolus insulin regimen was not changed during the study period. Results CGM glucose was significantly higher (p<0.05) from 19: 30 to 22: 30 and significantly lower (p<0.05) from 6: 30 to 8: 00 with basal InsDeg than with basal InsGla. The duration of hypoglycemia (<70 mg/dl) was the same regardless of whether basal InsDeg or basal InsGla was used. Conclusions The peak in the action profile of InsDeg lasts longer and is possibly stronger than that of InsGla.
Pharmacotherapy of type1 diabetes in children and adolescents: more than insulin?
THERAPEUTIC ADVANCES IN ENDOCRINOLOGY AND METABOLISM
Authors: Biester, Torben; Kordonouri, Olga; Danne, Thomas
For paediatric patients with type 1 diabetes, intensified insulin therapy with either multiple daily injection or insulin pump therapy is currently the only method of treatment. To optimize this therapy, insulin analogues are fixed parts of all therapy regimens. New ultra-rapid insulins seem to be beneficial not only in adults but also in this age group. New developments in long-acting analogues have demonstrated safety and will be regular in paediatrics, we hope, soon. Furthermore, the psychosocial approach for consideration of real-life aspects becomes more the focus of therapeutic regimens and is implemented into international guidelines. Technical improvements, such as continuous glucose monitoring, particularly in combination with pump therapy, support the great success of rapid-acting analogues by reducing hypoglycaemias. Non-insulin agents such as SGLT2-inhibitors show beneficial aspects in people with type 1 diabetes. For outpatient care with these currently off-label-used drugs, special training for measurement of ketones should be imperative.