A comparison of IDeg+IAsp versus IDet+IAsp in subjects with type 1 diabetes: subgroup analysis of Japanese subjects.

Abstract

Efficacy and safety were compared between insulin degludec (IDeg) once daily (OD) in combination with mealtime insulin aspart (IAsp) and insulin detemir (IDet) OD or twice daily (BID) in combination with mealtime IAsp in Japanese subjects with type 1 diabetes mellitus (T1DM). This was a post hoc analysis of a multinational, controlled, open-label, parallel-group, treat-to-target trial that randomised adults [aged≥18years (≥20years for Japan)] with T1DM for≥12months to basal IDeg OD (n=124) or IDet (n=62), both with mealtime bolus IAsp. The IDet dosing was adjusted to BID if required at≥8weeks. The estimated mean change in HbA1c from baseline to week 26 (the primary outcome measure) was -1.03% in the IDeg+IAsp group and -0.94% in the IDet+IAsp group (mean estimated treatment difference [ETD] -0.09; 95% confidence interval [CI] -0.29, 0.10). Significantly greater reductions in fasting plasma glucose were observed in the IDeg+IAsp group (mean ETD -39.36mg/dL; 95% CI -56.04, -22.68). Both groups had similar rates of confirmed hypoglycaemia (59.9 and 59.2 per patient-year of exposure [PYE] with IDeg+IAsp and IDet+IAsp, respectively). Rates of nocturnal confirmed hypoglycaemia were significantly lower with IDeg+IAsp than with IDet+IAsp (5.2 vs 9.5 episodes per PYE; estimated ratio 0.48; 95% CI 0.31, 0.75). Adverse event profiles were similar. The findings were consistent with those of the global trial population. IDeg+IAsp may represent an improvement on current standard treatments for Japanese patients with T1DM.