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Degludec

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https://www.readbyqxmd.com/read/28624930/basal-and-bolus-insulin-dose-changes-after-switching-basal-insulin-to-insulin-degludec-in-patients-with-type-1-diabetes%C3%A2-mellitus-a-pilot-study
#1
Yoshiyuki Hamamoto, Sachiko Honjo, Kanta Fujimoto, Shinsuke Tokumoto, Hiroki Ikeda, Yoshiharu Wada, Hiroyuki Koshiyama
BACKGROUND AND OBJECTIVES: Ultra-long-acting insulin degludec (DEG) has a longer duration of action and less daily variability relative to other basal insulin (BI), and thus may benefit patients with type 1 diabetes mellitus (T1DM). We examined the impact of switching BI to DEG on glycemic control and insulin dose in T1DM. METHODS: T1DM patients (n = 22; six male; mean age: 64.5 ± 12.6 years) receiving basal-bolus insulin therapy were included. Initially, the BI dose was replaced with DEG in a 1:1 ratio; 80-100% of the total dose was replaced with DEG for multiple basal insulin injections...
June 17, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28605603/efficacy-and-safety-of-degludec-versus-glargine-in-type-2-diabetes
#2
Steven P Marso, Darren K McGuire, Bernard Zinman, Neil R Poulter, Scott S Emerson, Thomas R Pieber, Richard E Pratley, Poul-Martin Haahr, Martin Lange, Kirstine Brown-Frandsen, Alan Moses, Simon Skibsted, Kajsa Kvist, John B Buse
Background Degludec is an ultralong-acting, once-daily basal insulin that is approved for use in adults, adolescents, and children with diabetes. Previous open-label studies have shown lower day-to-day variability in the glucose-lowering effect and lower rates of hypoglycemia among patients who received degludec than among those who received basal insulin glargine. However, data are lacking on the cardiovascular safety of degludec. Methods We randomly assigned 7637 patients with type 2 diabetes to receive either insulin degludec (3818 patients) or insulin glargine U100 (3819 patients) once daily between dinner and bedtime in a double-blind, treat-to-target, event-driven cardiovascular outcomes trial...
June 12, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28585180/efficacy-and-safety-of-insulin-degludec-for-hyperglycemia-management-in-noncritical-hospitalized-patients-with-diabetes-an-observational-study
#3
Natalino Simioni, Alessio Filippi, Marco Scardapane, Antonio Nicolucci, Maria Chiara Rossi, Vera Frison
INTRODUCTION: To assess the efficacy and safety of insulin degludec administered in a basal-bolus regimen according to the GesTIO protocol in noncritical hospitalized patients with T1DM and T2DM. METHODS: Mean blood glucose levels (BG) and their standard deviations (SD) at admission vs. discharge were compared in 52 subjects (48.1% ≥75 years) managed through a basal-bolus scheme including degludec. The percentages of patients with BG at target (140-180 mg/dl) or below at discharge and the incidence rate (and the 95% confidence interval for it) of hypoglycemia were assessed...
June 5, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28547206/glycemic-variability-in-type-1-diabetes-compared-with-degludec-and-glargine-on-the-morning-injection-an-open-label-randomized-controlled-trial
#4
Ryo Iga, Hiroshi Uchino, Ken Kanazawa, Shuki Usui, Masahiko Miyagi, Naoki Kumashiro, Hiroshi Yoshino, Yasuyo Ando, Takahisa Hirose
INTRODUCTION: Optimal adjustment of basal insulin to overcome hypoglycemia and glycemic variability (GV) depends on its duration of action and peak-less profile. Owing to the ability of long-acting basal insulin to avoid hypoglycemia, we titrated pre-meal glucose to normal fasting blood glucose, 80-110 mg/dL (4.5-6.1 mmol/L), and post-meal glucose to 80-140 mg/dL (4.5-7.8 mmol/L). The purpose of this study was to evaluate two basal insulin analogues degludec (IDeg) and glargine (IGlar), injected in the morning, for GV using continuous glucose monitoring (CGM) in type 1 diabetes (T1DM)...
May 25, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28537449/understanding-how-pharmacokinetic-and-pharmacodynamic-differences-of-basal-analog-insulins-influence-clinical-practice
#5
Jennifer Goldman, Christoph Kapitza, Jeremy Pettus, Tim Heise
This article reviews pharmacokinetic (PK) and pharmacodynamic (PD) concepts relating to the pharmacology of basal insulin analogs. Understanding the pharmacology of currently available long-acting basal insulins and the techniques used to assess PK and PD parameters (e.g. the euglycemic clamp method) is important when considering the efficacy and safety of these agents, and can help in understanding the rationale for specific dosing strategies when tailoring therapy for a specific patient. Basal insulins such as insulin glargine 100 units (U)/mL and insulin detemir show improved PK/PD characteristics compared with the intermediate-acting NPH insulin, with a longer duration of action, a more consistent glucose-lowering effect and less prominent concentration peaks...
May 24, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28523483/modeling-the-long-term-cost-effectiveness-of-ideglira-in-patients-with-type-2-diabetes-who-are-failing-to-meet-glycemic-targets-on-basal-insulin-alone-in-the-netherlands
#6
Barnaby Hunt, Divina Glah, Maarten van der Vliet
INTRODUCTION: Insulin degludec/liraglutide (IDegLira) is the first basal insulin and glucagon-like peptide-1 receptor agonist (GLP-1 RA) in a single pen injection device, and a once-daily treatment option for patients with type 2 diabetes mellitus (T2DM) who are uncontrolled on basal insulin and require treatment intensification. The objective of this analysis was to evaluate the long-term cost-effectiveness of IDegLira versus basal-bolus therapy (insulin glargine U100 + 3× daily insulin aspart) for patients with T2DM uncontrolled on basal insulin [HbA1c >53 mmol/mol (>7%)] in the Netherlands...
May 18, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28511140/different-impacts-of-acylated-and-non-acylated-long-acting-insulin-analogs-on-neural-functions-in-vitro-and-in-vivo
#7
Hiroshi Tsuneki, Hitomi Yoshida, Kosuke Endo, Norihiko Mori, Shuji Hosoh, Masaaki Tsuda, Tsutomu Wada, Toshiyasu Sasaoka
AIMS: Centrally administered insulin improves cognitive functions in patients with Alzheimer's disease; however, it remains unknown whether long-acting insulin analogs exert more pronounced effects than insulin. In the present study, we directly compared the effects of insulin and its analogs on neural functions in vitro and in vivo. METHODS: Cultured rat cerebral cortical neurons were treated with insulin, insulin glargine U100 (Gla), insulin detemir (Det), or insulin degludec (Deg)...
July 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28505544/real-life-experience-of-patients-starting-insulin-degludec-a-multicenter-analysis-of-1064-subjects-from-the-german-austrian-dpv-registry
#8
Barbara Bohn, Artur Zimmermann, Christian Wagner, Sigrun Merger, Desirée Dunstheimer, Florian Kopp, Katja Gollisch, Volker Zindel, Reinhard W Holl
BACKGROUND: The long-acting insulin analogue degludec is a therapeutic option for patients with type 1 (T1D) or type 2 diabetes (T2D). Aim of this analysis was to investigate differences in clinical characteristics of patients before and after initiating degludec use in a cohort of German/Austrian patients. METHODS: 1064 subjects with T1D/T2D and documented degludec use from the Diabetes-Patient-Follow-Up (DPV) registry were included. The follow-up cohort (n=421) comprised patients with available data before and 3-15months after switching to degludec...
July 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28475455/higher-concentration-insulins-an-overview-of-clinical-considerations
#9
REVIEW
Timothy S Reid, Fryn Schafer, Cynthia Brusko
Three higher concentration insulin products (insulin lispro 200 units/mL, insulin degludec 200 units/mL, and insulin glargine 300 units/mL) received US Food and Drug Administration (FDA) approval in 2015. Although human regular insulin 500 units/mL (U-500) was approved in 1997, a pen and dedicated U-500 syringe became available in 2016. These products offer more treatment options for the increasing numbers of patients requiring insulin to achieve and maintain glycemic targets. Higher concentration insulins have some unique safety and efficacy considerations...
June 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/28458515/united-states-experience-of-insulin-degludec-alone-or-in-combination-for-type-1-and-type-2-diabetes
#10
REVIEW
Marc Rendell
Insulin degludec has been the product of a sophisticated and systematic biochemical engineering program which began with the release of insulin detemir. The goal was to produce a long-lasting basal insulin with low individual variability. Certainly, this goal has been achieved. Degludec has a duration of action approaching twice that of glargine. Another advantage of degludec is in its lack of unpredictable copolymerization of added aspart. In several studies, degludec has shown lower rates of nocturnal hypoglycemia than glargine...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28442823/insulin-degludec-200-units-ml-is-associated-with-lower-injection-frequency-and-improved-patient-reported-outcomes-compared-with-insulin-glargine-100-units-ml-in-patients-with-type-2-diabetes-requiring-high-dose-insulin
#11
Mark L Warren, Louis B Chaykin, Serge Jabbour, Mae Sheikh-Ali, Charlotte T Hansen, Thor S S Nielsen, Paul Norwood
IN BRIEF Many patients with type 2 diabetes require high basal insulin doses, necessitating multiple injections, increasing patient burden, and resulting in reduced treatment adherence. This randomized, controlled, crossover trial compared the efficacy, safety, and patient-reported outcomes for a concentrated formulation of insulin degludec (200 units/mL) to those of insulin glargine in patients requiring high doses of basal insulin. By offering equivalent glycemic control while reducing the rate of confirmed hypoglycemia and the number of injections required for administration, insulin degludec 200 units/mL may be preferred by patients with type 2 diabetes who require high basal insulin doses...
April 2017: Clinical Diabetes: a Publication of the American Diabetes Association
https://www.readbyqxmd.com/read/28439138/bezlotoxumab
#12
Danial E Baker
Each month, subscribers to The Formulary Monograph Service receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to Pharmacy & Therapeutics Committees. Subscribers also receive monthly 1-page summary monographs on agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation/medication use evaluation (DUE/MUE) is also provided each month. With a subscription, the monographs are available online to subscribers...
March 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/28417535/rates-of-hypoglycaemia-are-lower-in-patients-treated-with-insulin-degludec-liraglutide-ideglira-than-with-ideg-or-insulin-glargine-regardless-of-the-hypoglycaemia-definition-used
#13
P Norwood, R Chen, E Jaeckel, I Lingvay, H Jarlov, L Lehmann, S Heller
AIMS: The rates of hypoglycaemia reported in clinical trials are affected by the definitions of hypoglycaemia used. This post-hoc analysis took data from two trials comparing the once-daily, fixed ratio combination of insulin degludec/liraglutide (IDegLira) with basal insulin regimens, and re-analysed these data using alternative hypoglycaemia definitions and stratified outcomes by dosing time and baseline characteristics. MATERIALS AND METHODS: Post hoc analyses of the DUAL I (patients uncontrolled on oral antidiabetic drugs) and DUAL V (patients uncontrolled on insulin glargine (IGlar) U100) trials were carried out using different definitions of hypoglycaemia and by whether treatments were administered in the AM or PM...
April 17, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28368217/long-acting-insulin-allergy-in-a-diabetic-child
#14
Carla Mastrorilli, Laura Rizzuti, Antonina Marta Cangelosi, Brunella Iovane, Giovanni Chiari, Carlo Caffarelli
Insulin allergy has been uncommon since the introduction of human recombinant insulin preparations; the prevalence is 2.4%. Insulin injection could elicit immediate reactions, which are usually induced by an IgE-mediated mechanism, within the first hour after drug administration. In the present study, we describe the case of a child who experienced immediate urticaria after long-acting insulin injection. A 9-year-old girl affected by type I diabetes mellitus referred a history of three episodes of urticaria 30 min after insulin subcutaneous injection...
April 1, 2017: International Journal of Immunopathology and Pharmacology
https://www.readbyqxmd.com/read/28349716/fixed-ratio-combination-therapy-with-glp-1-receptor-agonist-liraglutide-and-insulin-degludec-in-people-with-type-2-diabetes
#15
REVIEW
Lauge Østergaard, Christian Seerup Frandsen, Thomas Fremming Dejgaard, Sten Madsbad
A fixed combination of basal insulin degludec and glucagon-like peptide-1 receptor agonist (GLP-1RA) liraglutide (IDegLira; 50 units degludec/1.8 mg liraglutide) has been developed as a once daily injection for the treatment of type 2 diabetes (T2D). In the phase 3a trial programme 'Dual action of liraglutide and insulin degludec in type 2 diabetes' (DUAL™), five trials of 26 weeks duration and one trial of 32 weeks duration have evaluated the efficacy and safety of IDegLira compared with administration of insulin degludec, insulin glargine, liraglutide alone or placebo...
June 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28332144/efficacy-and-safety-of-ideglira-in-participants-with-type-2-diabetes-in-india-uncontrolled-on-oral-antidiabetic-drugs-and-basal-insulin-data-from-the-dual-clinical-trial-program
#16
Kamlesh Khunti, Viswanathan Mohan, Sunil M Jain, Trine Welløv Boesgaard, Kamilla Begtrup, Bipin Sethi
INTRODUCTION: The efficacy and safety of insulin degludec/liraglutide (IDegLira) has been evaluated in the Dual Action of Liraglutide and Insulin Degludec in Type 2 Diabetes (DUAL) phase 3 clinical trial program. In this post hoc analysis, we compared the efficacy and safety of IDegLira in the Indian subpopulation with the results from the global trial population of DUAL trials. The analysis includes participants uncontrolled on oral antidiabetic drugs (OADs) in DUAL I and DUAL IV and participants uncontrolled on basal insulin and OADs in DUAL II...
June 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28295934/insulin-degludec-lower-day-to-day-and-within-day-variability-in-pharmacodynamic-response-compared-with-insulin-glargine-300%C3%A2-u-ml-in-type-1-diabetes
#17
Tim Heise, Marianne Nørskov, Leszek Nosek, Kadriye Kaplan, Susanne Famulla, Hanne L Haahr
AIM: To compare day-to-day and within-day variability in glucose-lowering effect between insulin degludec (IDeg) and insulin glargine 300 U/mL (IGlar-U300) in type 1 diabetes. MATERIALS AND METHODS: In this double-blind, crossover study, patients were randomly assigned to 0.4 U/kg of IDeg or IGlar-U300 once daily for two treatment periods lasting 12 days each. Pharmacodynamic variables were assessed at steady-state from the glucose infusion rate profiles of three 24-hour euglycaemic glucose clamps (days 6, 9 and 12) during each treatment period...
March 14, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28294641/evaluation-of-the-long-term-cost-effectiveness-of-ideglira-versus-liraglutide-added-to-basal-insulin-for-patients-with-type-2-diabetes-failing-to-achieve-glycemic-control-on-basal-insulin-in-the-usa
#18
B Hunt, M Mocarski, W J Valentine, J Langer
BACKGROUND AND AIMS: IDegLira, a fixed ratio combination of insulin degludec and glucagon-like peptide-1 receptor agonist liraglutide, utilizes the complementary mechanisms of action of these two agents to improve glycemic control with low risk of hypoglycemia and avoidance of weight gain. The aim of the present analysis was to assess the long-term cost-effectiveness of IDegLira vs liraglutide added to basal insulin, for patients with type 2 diabetes not achieving glycemic control on basal insulin in the US setting...
July 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28282219/a-fixed-ratio-combination-of-insulin-degludec-and-liraglutide-ideglira-reduces-glycemic-fluctuation-and-brings-more-patients-with-type-2-diabetes-within-blood-glucose-target-ranges
#19
Allen B King, Athena Philis-Tsimikas, Eric S Kilpatrick, Irene H Langbakke, Kamilla Begtrup, Tina Vilsbøll
BACKGROUND: Reducing glycemic fluctuation is important for optimal diabetes management. This post hoc analysis examined glycemic fluctuations and the proportion of subjects achieving recommended blood glucose targets with the fixed ratio combination of insulin degludec and liraglutide (IDegLira) compared to insulin degludec (IDeg) and liraglutide alone. METHODS: We analyzed nine-point self-monitored blood glucose (SMBG) profiles from two randomized trials involving IDegLira in patients with type 2 diabetes (T2D), and continuous glucose monitoring (CGM) data from a subset of patients in one of these trials to assess glycemic fluctuation and day-to-day variability...
April 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28277867/the-role-of-the-new-basal-insulin-analogs-in-addressing-unmet-clinical-needs-in-people-with-type-1-and-type-2-diabetes
#20
Rosemarie Lajara, Eda Cengiz, Robert J Tanenberg
BACKGROUND: Despite improvements in anti-hyperglycemic therapies, there are many unmet clinical needs that hinder successful glycemic control in people being treated with current basal insulin analogs. OBJECTIVE: This paper reviews the unmet needs associated with current basal insulin therapy and describes the most recent basal insulins for the treatment of diabetes. METHODS: PubMed was searched for articles on basal insulin analogs published between 2000 and April 2016...
June 2017: Current Medical Research and Opinion
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