544-P: Efficacy and Safety of Insulin Degludec in Adults with T2D Macroalbuminuria and Chronic Kidney Disease Stage 2 and 3B

Abstract

This retrospective, observational study compared clinical outcomes of adults with T2D and chronic kidney disease (CKD) with macroalbuminuria switching from Gla-100/IDet/Gla-300 to IDeg. Endpoints were HbA1c change, hypoglycemia and units of insulin used (mean follow-up period, 36 months) in 90 patients. We established 2 groups: 46 patients with CKD stage 2 (CKD2) and 44 patients with CKD stage 3B (CKD3B). Hypoglycaemia was defined according to ADA criteria. The median age was significantly higher in the CKD3B (71.50±6.36 vs. 63.52±8.82 years). Average evolution of T2D was of 17 years in both. The CKD3B group had significantly more cardiovascular comorbidity (AMI, arteriopathy, hypertension, CHF) than CKD2. Initial basal insulin in both groups were detemir in 22.2%, glargine 100 in 60% and glargine 300 in 17.8% patients. A statistically significant improvement were observed in HbA1c (-1.71±0.25% in CKD2 and -1.28±1.17% in CKD3B p<0,0001) and in basal glycaemia (p<0.0001). Daily insulin basal dose decreased significantly in both groups at 36 months post-switch vs. pre-switch (p <0.001 and p <0.035 respectively). Hypoglycemia was significantly lower (81,3% to 34,2%, all p <0.001) post-switch vs. pre-switch. Renal function remained stable with a decrease in albuminuria in both groups. Conclusion: Degludec is effective, efficient and safe in renal patients with T2D and macroalbuminuria. Disclosure M. Garcia de Lucas: Speaker's Bureau; Spouse/Partner; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Janssen Pharmaceuticals, Inc., Lilly Diabetes, Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi. B. Aviles Bueno: Speaker's Bureau; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Janssen Pharmaceuticals, Inc., Novo Nordisk Inc. J. Olalla: None. J. Lopez-Fernandez: Consultant; Self; Lilly Diabetes, Sanofi. Other Relationship; Self; Almirall, S.A., Amgen Inc., AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., GEBRO, Janssen Pharmaceuticals, Inc., Lilly Diabetes, Merck Sharp & Dohme Corp., mundifarma, Novo Nordisk Inc., Sanofi.