Target Fasting Plasma Glucose (FPG) without Nocturnal Hypoglycemia in Patients with Type 1 Diabetes or Type 2 Diabetes—Results from SWITCH Trials

Abstract

Insulin degludec (degludec) is a basal insulin that results in a lower FPG than insulin glargine 100 units/mL (glargine U100), which may increase the risk of nocturnal hypoglycemia in patients with type 1 diabetes (T1D) or type 2 diabetes (T2D). This post-hoc analysis investigated the proportion of patients with T1D or T2D treated with degludec or glargine U100 meeting the ADA recommended upper limit of the pre-meal plasma glucose goal of <130 mg/dL (<7.2 mmol/L) at each visit (start and end of 16 week maintenance) without nocturnal hypoglycemia. Patients with T1D or T2D and with FPG measurements during the 16-week maintenance period of the SWITCH 1 (n=501) and SWITCH 2 (n=720) trials (randomized, double-blind, crossover, treat-to-target trials of patients treated with degludec or glargine U100) were included. Nocturnal hypoglycaemia was defined as any blood glucose-confirmed (<56 mg/dL [<3.1 mmol/L]) symptomatic event occurring from 00:01-05:59. In the SWITCH trials, significantly more patients with T1D or T2D treated with degludec achieved FPG target during the maintenance period, and did so without nocturnal hypoglycemia, compared with glargine U100 (Figure). In conclusion, compared with glargine U100, treatment with degludec was associated with greater opportunity to reach target FPG without an increased risk of nocturnal hypoglycemia. Disclosure C.H. Wysham: Advisory Panel; Self; Abbott, AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Janssen Pharmaceuticals, Inc., Sanofi. Consultant; Self; AstraZeneca, Janssen Pharmaceuticals, Inc., Novo Nordisk Inc., Sanofi. Speaker's Bureau; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Janssen Pharmaceuticals, Inc., Insulet Corporation, Novo Nordisk Inc., Sanofi. W. Lane: Advisory Panel; Self; Novo Nordisk A/S, Insulet Corporation, Intarcia Therapeutics, Inc., Sanofi. Research Support; Self; Novo Nordisk A/S, Eli Lilly and Company, Lexicon Pharmaceuticals, Inc., Sanofi, Dexcom, Inc.. Speaker's Bureau; Self; Novo Nordisk A/S, Insulet Corporation. S. Ladelund: Employee; Self; Novo Nordisk A/S, Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Technical University of Denmark. Research Support; Self; Metropolitan University College, Denmark. D. Tutkunkardas: Employee; Self; Novo Nordisk A/S. Stock/Shareholder; Self; Novo Nordisk A/S. S. Heller: Advisory Panel; Self; Eli Lilly and Company, Novo Nordisk A/S, Takeda, Sanofi-Aventis, Boehringer Ingelheim GmbH. Consultant; Self; Eli Lilly and Company, Novo Nordisk A/S. Speaker's Bureau; Self; Novo Nordisk A/S, Eli Lilly and Company, Merck Sharp & Dohme Corp., Takeda, AstraZeneca, Boehringer Ingelheim GmbH.