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Reduced rates of overall hypoglycaemia in patients with Type 1 diabetes after switching to insulin degludec: A European, multinational, multicentre, prospective, observational study (ReFLeCT)
Department of Medicine, Division of Metabolic Diseases, University of Padova, Padova, Italy.
Beta Cell Diabetes Centre, Chelsea and Westminster Hospital, London, UK; University of Surrey, Guildford, UK.
Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark.
Department of Internal Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
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2019 (English)In: Diabetic Medicine, ISSN 0742-3071, E-ISSN 1464-5491, Vol. 36, no Suppl. 1, p. 60-60Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Aims: To evaluate the safety and effectiveness of switching to once‐daily insulin degludec (degludec) from other basal insulins in patients with Type 1 diabetes in routine clinical practice.

Methods: ReFLeCT was a multicentre, prospective, observational study in seven European countries in patients (≥18 years) with Type 1 or Type 2 diabetes, whose physician planned to switch their basal insulin to degludec (ClinicalTrials.gov: NCT02392117). ReFLeCT comprised a four week baseline period (pre‐switch basal insulin) and a 12 month follow‐up period (degludec). For the Type 1 diabetes cohort presented here, primary endpoint was changed from baseline in the rate of overall hypoglycaemia recorded in patient diaries.

Results: Baseline characteristics (mean [SD]) for patients with Type 1 diabetes (n = 556) were: age 47.4 (15.7) years, diabetes duration 21.4 (13.5) years, HbA1c 8.1 (1.3)% (65.0 [14.2]mmol/mol), fasting plasma glucose (FPG) 8.8 (3.9)mmol/l, pre‐switch basal insulin dose 25.0 (14.1)u/day, body mass index (BMI) 26.1 (4.7)kg/m2 and body weight 76.4 (15.6)kg. Estimated rate ratios of overall (0.80 [0.74; 0.88]95%CI), non‐severe (0.81 [0.74; 0.88]95%CI), severe (American Diabetes Association definition; 0.28 [0.14; 0.56]95%CI) and nocturnal (00:01−05:59am; 0.61 [0.50; 0.73]95%CI) hypoglycaemia illustrated significantly lower rates during 12 month follow‐up vs baseline. HbA1c, FPG and basal insulin dose decreased significantly by –0.15% [–0.23; –0.07]95%CI (–1.64mmol/mol [–2.51; –0.77]95%CI), –0.54mmol/l [–0.95; –0.14]95%CI and –2.21u/day [–2.90; –1.53]95%CI, respectively, and body weight was 0.79kg [0.38; 1.20]95%CI higher, at 12 month follow‐up vs baseline.

Conclusion: Switching from other basal insulins to degludec significantly reduced the rates of hypoglycaemia and improved glycaemic control at lower basal insulin doses in patients with Type 1 diabetes in routine clinical practice.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019. Vol. 36, no Suppl. 1, p. 60-60
National Category
Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:oru:diva-73218DOI: 10.1111/dme.11_13883ISI: 000460421300144OAI: oai:DiVA.org:oru-73218DiVA, id: diva2:1297210
Conference
Diabetes UK Professional Conference 2019, Liverpool, UK, March 6-8, 2019
Available from: 2019-03-19 Created: 2019-03-19 Last updated: 2019-03-19Bibliographically approved

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Jendle, Johan

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