A Randomised Controlled Trial Comparing Insulin Degludec U100 and Glargine U100 for the Inpatient Management of Patients with Type 2 Diabetes

Link to article at PubMed

Diabetes Obes Metab. 2021 Sep 6. doi: 10.1111/dom.14544. Online ahead of print.


AIMS: Limited data exists about the use of insulin degludec in the hospital. This multicentre, non-inferiority, open-label, prospective randomised trial compared the safety and efficacy of insulin degludec-U100 and glargine-U100 for the management of hospitalized patients with type 2 diabetes.

METHODS: A total of 180 general medicine and surgery patients with an admission blood glucose (BG) between 7·8 - 22·2 mmol/L, treated with oral agents or insulin prior to hospitalization were randomly allocated (1:1) to a basal bolus regimen using degludec (n=92) or glargine (n=88), as basal and aspart before meals. Insulin dose was adjusted daily to a target BG between 3·9 - 10·0 mmol/L. The primary end point was difference in the mean hospital daily BG between groups.

RESULTS: Overall, the randomization BG was 12·2 ± 2·9 mmol/L and HbA1c 84 mmol/mol (9·8±2·0%). There were no differences in mean daily BG (10·0±2·1 vs. 10·0±2·5 mmol/L, p=0·9), proportion of BG in target range (54·5± 29% vs. 55·3 ± 28%, p=0·85), basal insulin (29·6 ± 13 vs 30·4 ± 18 units/day, p=0·85), length of stay (median (IQR): 6·7 (4·7-10·5) vs. 7·5 (4·7-11·6) days, p=0·61), hospital complications (23% vs. 23%, p=0·95) between treatment groups. There were no differences in the proportion of patients with BG <3.9 mmol/L (17% vs. 19%, p=0·75) or < 3·0 mmol/L (3·7% vs. 1·3%, p=0·62) between degludec and glargine.

CONCLUSION: Hospital treatment with degludec-U100 or glargine-U100 are equally safe and effective for the management of hyperglycaemia in general medicine and surgery patients with type 2 diabetes. This article is protected by copyright. All rights reserved.

PMID:34490700 | DOI:10.1111/dom.14544

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