Switching from Basal-Bolus Insulin Treatment to Insulin Degludec/Insulin Aspart Once-Daily Plus Dulaglutide Once-Weekly Injection

Abstract

We evaluated 21 patients with type 2 diabetes with poor glycemic control (glycated hemoglobin [HbA1c]: 11.0 %±1.8 %). After improving their glucose control with a basal-bolus therapy (BBT) during hospitalization, treatment was switched to a combination of insulin degludec/insulin aspart (IDegAsp) and dulaglutide (Dula). After switching, the insulin requirement decreased to 51.2 % (p <0.01), the mean blood glucose level decreased from 150±18 to 140±14 mg/dL (p <0.05), and the M values decreased from 11.5±5.5 to 8.0±5.0 (p <0.05). A meal tolerance test was performed. The CPR increased from 2.4±1.2 to 3.3±2.0 ng/mL (p <0.05) after 2 h. The HbA1c significantly decreased from 11.0 %±1.8 % to 7.0 %±1.5 % (p <0.01) 12 months after switching to combination therapy. Thirteen patients who received BBT as outpatient treatment were switched to combination therapy, and its effect was evaluated after one year. The HbA1c level showed a decreasing trend, from 7.3 %±0.7 % to 6.9 %±1.0 % (ns), and body weight decreased from 69.2±15.0 to 67.3±13.0 kg (p<0.01). Using a combination of IDegAsp and Dula, it was possible to switch from BBT to once-daily injection.