1
|
Taki K, Koyanagi M, Nagaoka S, Shingaki T. Treatment satisfaction, safety, and effectiveness of biosimilar insulin glargine is comparable in patients with type 2 diabetes mellitus after switching from insulin glargine or insulin degludec: a post-marketing safety study. Curr Med Res Opin 2020; 36:1975-1983. [PMID: 33030354 DOI: 10.1080/03007995.2020.1834374] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To evaluate insulin treatment satisfaction, safety, and effectiveness of biosimilar insulin glargine (GLY) in real-world clinical practice for Japanese patients with type 2 diabetes mellitus (T2DM) who switched from originator insulin glargine (100 U/mL) or insulin degludec treatment to GLY treatment. METHODS The Insulin Treatment Satisfaction Questionnaire (ITSQ) was used to assess treatment satisfaction in a subgroup analysis of a post-marketing safety study. Hypoglycemia incidence rates and blood glucose control are also reported during the 12-month observation period for GLY-switched patients. RESULTS Of 1104 patients with T2DM enrolled to participate, 565 patients switched from either insulin glargine U100/mL (n = 470) or insulin degludec (n = 95) to GLY. The mean total change from baseline to 3 months for total ITSQ score was 1.35 (95% confidence interval [CI] - 0.13 to 2.83, p = .073) for patients who switched from insulin glargine and 2.63 (95% CI -1.43 to 6.70, p = .195) for patients who switched from insulin degludec to GLY treatment. The mean change from baseline to 12 months in hypoglycemia events reported per month was -0.04% (95% CI -0.12 to 0.03, p = .236) for patients who switched from insulin glargine and no change for patients who switched from insulin degludec (0.00, 95% CI -0.20 to 0.20, p = 1.000). Non-significant mean changes from baseline to 12 months were observed for hemoglobin A1c and fasting plasma glucose in GLY-switched patients. CONCLUSIONS Treatment satisfaction does not change significantly in Japanese patients with T2DM who switch to GLY from the reference product or from insulin degludec. Safety and effectiveness over a 12-month period were similar in GLY-treated patients who switched from either insulin glargine or insulin degludec. CLINICALTRIALS.GOV Not applicable.
Collapse
Affiliation(s)
- Kentaro Taki
- Medicines Development Unit-Japan, Eli Lilly Japan K. K, Kobe, Japan
| | - Momoha Koyanagi
- Medicines Development Unit-Japan, Eli Lilly Japan K. K, Kobe, Japan
| | - Soshi Nagaoka
- Medicines Development Unit-Japan, Eli Lilly Japan K. K, Kobe, Japan
| | | |
Collapse
|
2
|
Preumont V, Buysschaert M. Current status of insulin degludec in type 1 and type 2 diabetes based on randomized and observational trials. DIABETES & METABOLISM 2020; 46:83-88. [PMID: 31055056 DOI: 10.1016/j.diabet.2019.04.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 04/08/2019] [Accepted: 04/22/2019] [Indexed: 06/09/2023]
Abstract
Insulin degludec is a new ultra-long-action basal insulin. Using treat-to-target protocols, controlled trials have shown comparable HbA1c reductions with insulin degludec and comparators in both type 1 and type 2 diabetes. Most studies identify, however, better control of fasting plasma glucose with insulin degludec vs. either insulin glargine U100 or detemir, and all have consistently demonstrated clinically relevant decreases in (nocturnal) hypoglycaemic episodes. These characteristics have provided added therapeutic value for insulin degludec in clinical practice. Thus, the aim of this review is to discuss, within the context of randomized and observational studies, the clinical effects of insulin degludec use in type 1 and type 2 diabetes.
Collapse
Affiliation(s)
- V Preumont
- Endocrinology and Nutrition, Cliniques universitaires Saint-Luc, Brussels, Belgium.
| | - M Buysschaert
- Endocrinology and Nutrition, Cliniques universitaires Saint-Luc, Brussels, Belgium
| |
Collapse
|
3
|
Tanaka N, Yabe D, Murotani K, Ueno S, Kuwata H, Hamamoto Y, Kurose T, Takahashi N, Akashi T, Matsuoka T, Osonoi T, Minami M, Shimono D, Seino Y. Mental distress and health-related quality of life among type 1 and type 2 diabetes patients using self-monitoring of blood glucose: A cross-sectional questionnaire study in Japan. J Diabetes Investig 2018; 9:1203-1211. [PMID: 29493881 PMCID: PMC6123045 DOI: 10.1111/jdi.12827] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 01/18/2018] [Accepted: 02/20/2018] [Indexed: 12/01/2022] Open
Abstract
AIMS/INTRODUCTION The present multicenter, cross-sectional survey was initiated to evaluate self-monitoring of blood glucose (SMBG)-associated mental distress among patients with diabetes. MATERIALS AND METHODS The survey was carried out in patients with type 1 diabetes and type 2 diabetes using SMBG recruited from 42 medical institutions. Profiles of Mood States 2 and diabetes therapy-related quality of life questionnaires were used to evaluate mood status and health-related quality of life. Two original questionnaires were also developed to evaluate SMBG 'importance,' 'painfulness' and 'confidence' among patients, and to evaluate physician attitudes to SMBG use. RESULTS Questionnaires from 517 type 1 diabetes and 1,648 type 2 diabetes patients showed that 46.0% of type 1 diabetes and 37.5% of type 2 diabetes patients reported 'painfulness,' and that these patients reporting 'painfulness' showed significantly higher Profiles of Mood States 2 scores, lower diabetes therapy-related quality of life scores and higher glycated hemoglobin compared with those not reporting 'painfulness,' whereas the number of their daily SMBG tests were comparable. Patients reporting 'painfulness' also reported that SMBG use was significantly less important. Whether or not patients recognized the importance of SMBG use was well correlated with the frequency of physicians checking patient diaries. CONCLUSIONS Type 1 diabetes and type 2 diabetes patients reporting 'painfulness' in SMBG use had more mental distress, lower health-related quality of life and higher glycated hemoglobin regardless of their number of daily SMBG tests. The importance of SMBG use was recognized less by patients experiencing pain, and the importance of SMBG use was recognized more in medical institutions in which physicians regularly checked SMBG diaries to provide meaningful feedback to patients in clinical settings.
Collapse
Affiliation(s)
- Nagaaki Tanaka
- Yutaka Seino Distinguished Center for Diabetes ResearchKansai Electric Power Medical Research InstituteKobeJapan
- Center for Diabetes, Endocrinology and MetabolismKansai Electric Power HospitalOsakaJapan
| | - Daisuke Yabe
- Yutaka Seino Distinguished Center for Diabetes ResearchKansai Electric Power Medical Research InstituteKobeJapan
| | - Kenta Murotani
- Division of BiostatisticsClinical Research CenterAichi Medical University HospitalNagakuteJapan
| | - Shinji Ueno
- Yutaka Seino Distinguished Center for Diabetes ResearchKansai Electric Power Medical Research InstituteKobeJapan
- Center for Diabetes, Endocrinology and MetabolismKansai Electric Power HospitalOsakaJapan
| | - Hitoshi Kuwata
- Yutaka Seino Distinguished Center for Diabetes ResearchKansai Electric Power Medical Research InstituteKobeJapan
- Center for Diabetes, Endocrinology and MetabolismKansai Electric Power HospitalOsakaJapan
| | - Yoshiyuki Hamamoto
- Yutaka Seino Distinguished Center for Diabetes ResearchKansai Electric Power Medical Research InstituteKobeJapan
- Center for Diabetes, Endocrinology and MetabolismKansai Electric Power HospitalOsakaJapan
- Center for Metabolism and Clinical NutritionKansai Electric Power HospitalOsakaJapan
| | - Takeshi Kurose
- Yutaka Seino Distinguished Center for Diabetes ResearchKansai Electric Power Medical Research InstituteKobeJapan
- Center for Diabetes, Endocrinology and MetabolismKansai Electric Power HospitalOsakaJapan
| | | | | | | | | | | | | | - Yutaka Seino
- Yutaka Seino Distinguished Center for Diabetes ResearchKansai Electric Power Medical Research InstituteKobeJapan
- Center for Diabetes, Endocrinology and MetabolismKansai Electric Power HospitalOsakaJapan
| |
Collapse
|
4
|
Ishii H, Kim HR, Crawford B. The revalidation of the diabetes treatment-related quality-of-life (DTR-QOL) questionnaire in Japan. Diabetol Int 2018; 10:93-101. [PMID: 31139527 DOI: 10.1007/s13340-018-0371-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 07/24/2018] [Indexed: 01/19/2023]
Abstract
Objectives The objectives of this study were to develop a conceptual framework for the diabetes treatment-related quality of life (DTR-QOL) and validate the new structure of the DTR-QOL. Methods This study was conducted in two stages. First, items were collated into similar concepts to develop a new conceptual framework for the DTR-QOL. Next, psychometric analyses were conducted. Analyses included a distribution of responses (and domains) with a focus on floor/ceiling effects, item convergent/discriminant validity, internal consistency reliability (where possible), clinical validity, known-group analysis, and concurrent validity with the Diabetes Treatment Satisfaction Questionnaire and SF-8. Known groups were evaluated using "Glycemic control in the last month", "Concerned with weight gain in the last month", "Current health status", and "Degree of communication with clinician". To evaluate the reliability of each scale, test-retest were assessed. Results The DTR-QOL items were reconstructed into seven domains based on similar concepts: usual activities, pain/discomfort, anxiety/depression, satisfaction, positive feelings, negative feelings, and feeling troubled. Although there were ceiling effects on most items, when patients reported having a hypoglycemic event in the last month, score distributions found fewer ceiling effects indicating that items are able to respond to clinical changes. Internal consistency reliability was met for all scales except satisfaction (α = 0.69) and pain/discomfort (α = 0.66). Clinical validity, known groups, and concurrent validity were met. Test-retest met acceptable levels for all scales except positive feelings. Conclusions The restructuring of the DTR-QOL resulted in an acceptable measure with domains that are easily interpreted and allow physicians to better measure more specific impacts on their patients.
Collapse
Affiliation(s)
- Hitoshi Ishii
- 1Department of Diabetology, Nara Medical University Hospital, 840 Shijo-Cho, Kashihara, Nara Japan
| | - Hyunchung Ray Kim
- Syneos Health, 5F Urbannet Nihonbashi 2-Chome Building, 2-1-3 Nihonbashi, Chuo-ku, Tokyo, 103-0027 Japan
| | - Bruce Crawford
- Syneos Health, 5F Urbannet Nihonbashi 2-Chome Building, 2-1-3 Nihonbashi, Chuo-ku, Tokyo, 103-0027 Japan
| |
Collapse
|
5
|
Lecumberri E, Ortega M, Iturregui M, Quesada JA, Vázquez C, Orozco D. Quality-of-life and treatment satisfaction in actual clinical practice of patients with Type 1 diabetes mellitus (T1DM) and hypoglycemia treated with insulin degludec. Curr Med Res Opin 2018; 34:1053-1059. [PMID: 29300101 DOI: 10.1080/03007995.2017.1419172] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The frequency of hypoglycemia in patients with T1DM is high and results in a poorer quality-of-life and low treatment satisfaction. The aim of this study is to demonstrate the effect of changing the basal insulin (glargine or detemir) to insulin degludec. METHODS An observational analytical study was conducted on a cohort of 110 patients with T1DM. The patients were administered three questionnaires to assess treatment satisfaction (DTSQ-s), fear of hypoglycemia (HFS-II) and quality-of-life (EQ-5D), before the change and at 6 months. A statistical analysis was performed for repeated measures. RESULTS The 110 patients with T1DM had a mean diabetes duration of 19.1 (11.6) years, 53.6% were men, the mean age was 43.4 (15.4) years, and the mean BMI was 25.2 (4.2) kg/m2. After 6 months, there was a significant reduction in baseline fasting plasma glucose (from 159.1 [68.6] to 132.9 [56.6] mg/dL; p < .001) and HbA1c levels (from 7.82% [1.2] to 7.6% [1.2]; p = .002). A reduction in the number of severe hypoglycemic episodes (0.17 [0.5] vs 0.05 [0.2]; p = .03) was observed. At 6 months, an improvement in the DTSQ-s (from 24.3 [5.5] to 27.3 [5.4]; p < .001) was observed. There was a decrease in the mean number of perceived hypoglycemia (from 2.9 [1.4] to 2.3 [1.4]; p = .003) and hyperglycemia (from 3.5 [1.3] to 2.7 [1.4]; p < .001). There was also a decrease in the mean HFS-II score (from 24.1 [14.0] to 20.0 [13.0]; p < .001). There were no significant differences in the EQ-5D index (from 0.91 [0.14] to 0.89 [0.16]; p = .13). However, there was significant improvement in the EQ-5D as measured by VAS (from 70.5 [16.5] to 73.6 [14.4]; p = .04). CONCLUSIONS The change to insulin degludec in patients with T1DM improved their metabolic control, increased their satisfaction with the insulin therapy, and offered them improved quality-of-life.
Collapse
Affiliation(s)
- Edurne Lecumberri
- a Medicine Department , Autónoma University of Madrid , Madrid , Spain
- b Endocrinology Department , University Hospital Fundación Jiménez Díaz , Madrid , Spain
| | - Maite Ortega
- a Medicine Department , Autónoma University of Madrid , Madrid , Spain
- b Endocrinology Department , University Hospital Fundación Jiménez Díaz , Madrid , Spain
| | - Marta Iturregui
- b Endocrinology Department , University Hospital Fundación Jiménez Díaz , Madrid , Spain
| | | | - Clotilde Vázquez
- a Medicine Department , Autónoma University of Madrid , Madrid , Spain
- b Endocrinology Department , University Hospital Fundación Jiménez Díaz , Madrid , Spain
| | - Domingo Orozco
- c Medicine Department , Miguel Hernández University of Elche , Alicante , Spain
| |
Collapse
|
6
|
Oita M, Miyoshi H, Ono K, Nakamura A, Cho KY, Nomoto H, Yamamoto K, Omori K, Manda N, Kurihara Y, Aoki S, Atsumi T. Satisfaction and efficacy of switching from daily dipeptidyl peptidase-4 inhibitors to weekly trelagliptin in patients with type 2 diabetes-Randomized controlled study. Endocr J 2018; 65:141-150. [PMID: 29093280 DOI: 10.1507/endocrj.ej17-0303] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
We compared treatment satisfaction between daily dipeptidyl peptidase-4 (DPP-4) inhibitors and a weekly DPP-4 inhibitor in patients with type 2 diabetes. The study was a 12-week, open-label, randomized, multicenter, controlled trial. Participants were Japanese patients with type 2 diabetes who had received daily DPP-4 inhibitors for more than 3 months. Patients were randomly assigned to a treatment cohort: (1) a group that continued taking daily DPP-4 inhibitors (daily group); or (2) a group that switched from daily DPP-4 inhibitors to a weekly DPP-4 inhibitor, trelagliptin (weekly group). The primary outcome was the change in treatment satisfaction levels from baseline to 12 weeks between the two groups, according to Diabetes Treatment Satisfaction Questionnaire (DTSQ) and Diabetes Therapy-Related Quality of Life (DTR-QOL) questionnaire scores. The changes in glycemic control and body weight were also assessed. Of 49 patients initially enrolled in the study, 47 completed the study. The change in DTSQ scores in the weekly group was not significantly different from that in the daily group. However, the improvements in total score and subscale domains 1 and 2 in the DTR-QOL analysis, which relate to burden on social/daily activities and anxiety/dissatisfaction with treatment, were significantly greater in the weekly group than the daily group (p = 0.048, 0.013 and 0.045, respectively). Mean changes in glycated hemoglobin levels and body weight were comparable between the groups. Switching from daily DPP-4 inhibitors to a weekly DPP-4 inhibitor, trelagliptin, could partially improve treatment satisfaction levels in patients with type 2 diabetes without affecting glycemic control.
Collapse
Affiliation(s)
- Mayuko Oita
- Division of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University Hospital, North 15, West 7, Kita-ku, Sapporo 060-8638, Japan
| | - Hideaki Miyoshi
- Division of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University Hospital, North 15, West 7, Kita-ku, Sapporo 060-8638, Japan
| | - Kota Ono
- Clinical Research and Medical Innovation Center, Hokkaido University Hospital, North 15, West 7, Kita-ku, Sapporo 060-8638, Japan
| | - Akinobu Nakamura
- Division of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University Hospital, North 15, West 7, Kita-ku, Sapporo 060-8638, Japan
| | - Kyu Yong Cho
- Division of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University Hospital, North 15, West 7, Kita-ku, Sapporo 060-8638, Japan
- Clinical Research and Medical Innovation Center, Hokkaido University Hospital, North 15, West 7, Kita-ku, Sapporo 060-8638, Japan
| | - Hiroshi Nomoto
- Division of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University Hospital, North 15, West 7, Kita-ku, Sapporo 060-8638, Japan
| | - Kohei Yamamoto
- Division of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University Hospital, North 15, West 7, Kita-ku, Sapporo 060-8638, Japan
| | - Kazuno Omori
- Division of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University Hospital, North 15, West 7, Kita-ku, Sapporo 060-8638, Japan
| | - Naoki Manda
- Manda Memorial Hospital, South 2, West 1, Chuo-ku, Sapporo 060-0062, Japan
| | - Yoshio Kurihara
- Kurihara Clinic, Athubethuchuo 3-5, Atsubetsu-ku, Sapporo 004-0053, Japan
| | - Shin Aoki
- Aoki Clinic, Nango dori 1, North 1-1, Shiroishi-ku, Sapporo 003-0023, Japan
| | - Tatsuya Atsumi
- Division of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University Hospital, North 15, West 7, Kita-ku, Sapporo 060-8638, Japan
| |
Collapse
|
7
|
Anderson SL, Trujillo JM, Anderson JE, Tanenberg RJ. Switching basal insulins in type 2 diabetes: practical recommendations for health care providers. Postgrad Med 2017; 130:229-238. [PMID: 29260929 DOI: 10.1080/00325481.2018.1419048] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Basal insulin remains the mainstay of treatment of type 2 diabetes when diet changes and exercise in combination with oral drugs and other injectable agents are not sufficient to control hyperglycemia. Insulin therapy should be individualized, and several factors influence the choice of basal insulin; these include pharmacological properties, patient preferences, and lifestyle, as well as health insurance plan formularies. The recent availability of basal insulin formulations with longer durations of action has provided further dosing flexibility; however, patients may need to switch agents throughout therapy for a variety of personal, clinical, or economic reasons. Although a unit-to-unit switching approach is usually recommended, this conversion strategy may not be appropriate for all patients and types of insulin. Glycemic control and risk of hypoglycemia must be closely monitored by health care providers during the switching process. In addition, individual changes in care and formulary coverage need to be adequately addressed in order to enable a smooth transition with optimal outcomes.
Collapse
Affiliation(s)
- Sarah L Anderson
- a Department of Clinical Pharmacy , University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences , Aurora , CO , USA
| | - Jennifer M Trujillo
- a Department of Clinical Pharmacy , University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences , Aurora , CO , USA
| | | | - Robert J Tanenberg
- c Brody School of Medicine, Division of Endocrinology , East Carolina University , Greenville , NC , USA
| |
Collapse
|
8
|
Aso Y, Suzuki K, Chiba Y, Sato M, Fujita N, Takada Y, Murano S, Kuroda H. Effect of insulin degludec versus insulin glargine on glycemic control and daily fasting blood glucose variability in insulin-naïve Japanese patients with type 2 diabetes: I'D GOT trial. Diabetes Res Clin Pract 2017. [PMID: 28651211 DOI: 10.1016/j.diabres.2017.06.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AIMS Insulin degludec (IDeg) is an ultra-long-acting insulin that has a smooth time/action profile over more than 42h. The present study compared the effects of IDeg and insulin glargine (IGlar) on HbA1c reduction and on within-subject day-to-day variability of fasting blood glucose (FBG) in insulin-naïve patients with type 2 diabetes. SUBJECTS AND METHODS Eligible patients were randomly allocated at a 3:1 ratio to receive once-daily IDeg (n=31) or IGlar (n=12). Both basal insulins were administered before breakfast and titrated to achieve a target FBG <110mg/dl. The primary endpoints were the change in HbA1c from baseline to 24weeks of treatment, as well as the standard deviation (SD) and coefficient of variation (CV) of FBG from 8 to 12weeks and from 20 to 24weeks. Secondary endpoints included the QOL evaluated by the Diabetes Therapy-Related QOL questionnaire. RESULTS After 24weeks, HbA1c was decreased by 1.6% in the IDeg group and 1.7% in the IGlar at the same insulin dosage. At 24weeks, FBG was significantly lower in the IDeg group than in the IGlar group and the CV of FBG was significantly smaller in the IDeg group. The frequency of total and severe hypoglycemic episodes did not differ between the groups. In the IDeg group, QOL showed significant improvement regarding anxiety and dissatisfaction with treatment. CONCLUSIONS Treatment with IDeg or IGlar achieved similar improvement in glycemic control in insulin-naïve patients with type 2 diabetes. The day-to-day variation of FBG was smaller in patients receiving IDeg.
Collapse
Affiliation(s)
- Yoshimasa Aso
- Department of Endocrinology and Metabolism, Dokkyo Medical University, Mibu, Tochigi, Japan.
| | - Kunihiro Suzuki
- Department of Endocrinology and Metabolism, Dokkyo Medical University, Mibu, Tochigi, Japan
| | | | - Minoru Sato
- NHO Utsunomiya National Hospital, Utsunomiya, Tochigi, Japan
| | - Nobuya Fujita
- Saiseikai Utsunomiya Hospital, Utsunomiya, Tochigi, Japan
| | | | | | | |
Collapse
|
9
|
Kaku K, Wolden ML, Hyllested-Winge J, Nørtoft E. Insulin Degludec in Clinical Practice: A Review of Japanese Real-World Data. Diabetes Ther 2017; 8:189-195. [PMID: 28091878 PMCID: PMC5306124 DOI: 10.1007/s13300-017-0225-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION In this literature review we evaluated the real-world clinical effectiveness of switching Japanese diabetic patients from their current insulin regimen to insulin degludec (IDeg). METHODS Studies were identified from Japanese Diabetes Society (JDS) abstracts (2014-2015) and PubMed (2012 onwards). Inclusion criteria were: Japanese population, >15 participants, and studies switching patients from basal or basal-bolus insulin regimens to IDeg. Randomized controlled trials and case reports were excluded. Weighted mean changes in safety and effectiveness endpoints were calculated using the number of patients in each study. RESULTS In total, 81 JDS abstracts and seven manuscripts met the search criteria, representing 4238 patients [1028 with type 1 diabetes (T1D), 602 with type 2 diabetes (T2D), 2608 with unspecified or mixed diabetes]. Glycated hemoglobin (HbA1c) was reported in 93% of studies, with an improvement in 84% of these (51% significant, 33% numerical), no change in 12%, and worsening in 4% (3% numerical, 1% significant). Across all studies, the weighted mean absolute change in HbA1c was -0.3% (-2.7 mmol/mol). Basal insulin dose was reported in 58% of studies and was lower in 60% of these (30% significant, 30% numerical), numerically unchanged in 26%, and higher in 14% (2% significant, 12% numerical). The weighted mean change in basal insulin dose was -4.8% and -3.0% for all studies and for studies with only significant results, respectively. The weighted mean change in basal dose based on all studies was -8.9, -5.5, and -2.9% for the T1D, T2D, and unspecified patient populations, respectively. Hypoglycemia was recorded in 31% of the studies. After switching treatment to IDeg, 55% of studies reported decreased hypoglycemia, 29% no change, and 16% an increase. Quality of life (QoL) was measured in 11% of studies, of which 82% reported improved QoL after switching, and 18% reported no change in QoL. CONCLUSION Switching from a conventional basal insulin to IDeg has the potential to improve HbA1c with a lower insulin dose. Switching to IDeg may also provide a reduced risk of hypoglycemia and improvement in QoL. FUNDING Novo Nordisk.
Collapse
Affiliation(s)
- Kohei Kaku
- Kawasaki Medical School, Okayama, Japan.
| | | | | | | |
Collapse
|