1型糖尿病患者における既存持効型インスリンからインスリンデグルデクへの変更による血糖コントロールの評価

抄録

Insulin degludec shows longer lasting and more stable anti-hyperglycemic effects than the conventional long-acting insulin analogs, glargine and detemir. An injection of degludec once a day may stabilize blood glucose levels in patients who have not responded to injections of glargine or detemir twice a day. In the present study, we retrospectively investigated the impact of switching basal insulin from glargine or detemir twice a day to degludec once a day in the morning on glucose levels in type 1 diabetic patients. In 11 study patients, HbA1c and glucose levels before breakfast were similar during a 6-month follow-up. The standard deviation of glucose levels was significantly lower 3 months after than before switching to degludec. No significant differences were observed in the frequency of hyperglycemia or hypoglycemia between before and after switching. While the dose of bolus insulin was similar, that of basal insulin was gradually decreased after switching. These results suggest that switching basal insulin from glargine or detemir twice a day to degludec once a day in the morning decreases the day-to-day variability before breakfast in glucose levels in type 1 diabetic patients and also reduces the frequency of injections.