184 Utility of an ultra-long acting insulin to treat cystic fibrosis related diabetes

Abstract

Objectives Insulin Degludec is a new ultra-long-acting basal insulin with a half-life of 25 hours. Its long duration of action allows for scope in the timing of administration and it is claimed to have less propensity to cause nocturnal hypoglycaemia [Wang F, et al. Diabetes Metab Syndr Obes. 2012; 5: 191–204] but its efficacy and side effect profile have not been assessed. Methods We prescribed insulin Degludec to 9 adult CFRD patients [mean FEV1 65% predicted, mean age 27.7 years, 5 female] who had displayed erratic glucose profiles on continuous glucose monitoring (CGM). Diabetic markers (CGM, HBA1c, FEV1 and weight) and overall health were assessed pre and post therapy. Additionally, we conducted a qualitative questionnaire to survey patients' experiences. Results Overall glucose profile, HbA1c, and time spent within normal range improved on Degludec therapy. There was also a reduction in time spent with raised glucose levels and a marked reduction in hypoglycaemic episodes including overnight events. Pre DegludecOn DegludecMean FEV165%62.8%Mean weight (kg)57.358.2Mean HbA1C (IFCC)65.254.5Nocturnal hypoglycaemic episodes15 [2.5]6 [0.5]Median % time with glucose in normal range [IQR]43 [20–58]56 [42–64]Median % time raised glucose [IQR]52 [37–78]43 [33–56] Conclusion Patients found the injection device user-friendly and appreciated the dosing schedule flexibility. Our experience shows that this ultra-long-acting form of insulin is well tolerated by individuals with CFRD and seems to improve their glucose profiles. The low rates of hypoglycaemia suggest that it is safe. Insulin Degludec is a useful additional tool for the treatment of CFRD.