Abstract
Diabetes mellitus (DM) is a public health issue, affecting around 382 million people worldwide. In order to achieve glycemic goals, insulin therapy is the frontline therapy for type 1 DM patients; for patients with type 2 DM, use of insulin therapy is an option as initial or add-on therapy for those not achieving glycemic control. Despite insulin therapy developments seen in the last decades, several barriers remain for insulin initiation and optimal maintenance in clinical practice. Fear of hypoglycemia, weight gain, pain associated with blood testing and injection-related pain are the most cited reasons for not starting insulin therapy. However, new generation of basal insulin formulations, with longer length of action, have shown the capability of providing adequate glycemic control with lower risk of hypoglycemia.
Highlights
Diabetes mellitus (DM) is a public health issue, affecting around 382 million people worldwide
Insulin therapy is recommended as frontline therapy for type 1 DM patients; for patients with type 2 DM, use of insulin is an option as initial or add-on therapy for those not achieving glycemic control with initial oral drugs [2]
The main secondary endpoint was the percentage of patients with one or more confirmed or severe nocturnal hypoglycemia event (≤3.9 mmol/L) reported between week 9 and month 6 and it was lower in patients receiving glargine 300U (21.6 %) than glargine 100U (27.9 %), with a risk reduction of 23 %
Summary
Diabetes mellitus (DM) is a public health issue, affecting around 382 million people worldwide. Another 1-year large phase 3 trial (BEGIN Once Long) randomized 1030 patients (3:1) with type 2 DM, insulin-naïve, inadequately controlled with oral antidiabetic drugs (A1C 7–10 %) to receive insulin degludec or glargine once daily, both combined with metformin [34].
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