Abstract
Background: Cardiovascular disease is a frequent complication of type 1 diabetes (T1D). We evaluated the effectiveness of switching from glargine to degludec in reducing the cardiovascular risk factors, the Framingham risk score (FRS) and visceral adiposity index (VAI) in patients with T1D and autoimmune polyglandular syndrome (APS).Methods: We selected 66 T1D outpatients who had been on stable treatment with glargine for at least 5 years. Among them, 30 patients maintained glargine (group A), while 36 were switched to degludec (group B) for 12 months. At baseline and after 12 months of observation, clinical and metabolic parameters, insulin dose, 30-days blood glucose (BG) self monitoring, VAI and FRS were obtained.Results: At baseline, patients in group B had more hypoglycaemic episodes and prevalence of hypertension than those in group A. After 12 months on degludec, patients in group B had a significant decrease in BMI (p = 0.003), waist circumference (p < 0.001), total daily insulin as U/day and U/kg (p = 0.001 for both), basal insulin as U/day and U/kg (p = 0.001 for both), HbA1c (p < 0.001), mean (p = 0.035) and standard deviation of daily BG (p = 0.017), mean pre-meal BG (p = 0.016), number of hypoglycaemic episodes (p = 0.001), VAI (p = 0.012) and FRS (p = 0.019) and a significant increase in HDL-C (p < 0.001), compared to baseline. At 12 months of treatment a significant decrease in BMI (p = 0.017), WC (p = 0.003), SBP (p = 0.001), DBP (p = 0.005), basal insulin as U/day (p = 0.018) and U/kg (p = 0.045), HbA1c (p = 0.040) and FRS (p = 0.010) was observed in group B compared to group A.Conclusions: Our preliminary data suggest that 12 months' treatment with degludec is associated with an improvement of glycaemic control, cardiometabolic and cardiovascular risk, compared to glargine, in patients with T1D and APS.
Highlights
Increased cardiovascular risk is widely recognized as a complication of type 1 diabetes (T1D) due to multiple risk factors, such as HbA1c, blood pressure, lipids, smoking, and visceral obesity [1]
The current study aimed to evaluate the effectiveness of switching from glargine to degludec in a real-world setting, in reducing a composite index of cardiovascular risk [the Framingham risk score (FRS)] [23] and of cardiometabolic risk, the visceral adiposity index (VAI), in patients with T1D and autoimmune polyglandular syndrome (APS) for a 12-month period
We carefully selected data of 30 patients who were on glargine treatment and maintained this basal insulin and 36 patients who were on glargine treatment and were switched to degludec, for a 12 month-period
Summary
Increased cardiovascular risk is widely recognized as a complication of type 1 diabetes (T1D) due to multiple risk factors, such as HbA1c, blood pressure, lipids, smoking, and visceral obesity [1]. T1D is a complex disease characterized by the presence of many factors initiating or modulating immune response leading to development of the disease [4]. It can be associated with other autoimmune diseases in the spectrum of the autoimmune polyglandular syndrome (APS), which is characterized by poor quality of life and increased morbidity and mortality, compared to T1D alone [5]. We evaluated the effectiveness of switching from glargine to degludec in reducing the cardiovascular risk factors, the Framingham risk score (FRS) and visceral adiposity index (VAI) in patients with T1D and autoimmune polyglandular syndrome (APS)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
