Stable Glucose Research Articles

Effect of Newer Long-Acting Insulins on Hypoglycemia and Fracture Risk Among People with Diabetes: A Systematic Review.

To investigate the effect of newer long-acting insulins on the risk of hypoglycemic episodes and fractures in people with diabetes. Hypoglycemic episodes are the critical limiting factor in glycemic management due to a deteriorating effect on quality of life. Hypoglycemia may in severe cases lead to unconsciousness and thus fractures. Newer long-acting insulins may result in more stable blood glucose levels, less hypoglycemic episodes, and reduced risk of fractures. Use of insulin increases risk of hypoglycemic episodes, and hypoglycemic episodes increase risk of fractures plausible due to falls. Newer ultra-long-acting insulins reduce risk of hypoglycemic episodes compared to older alternatives, and they are thus promising for reducing fracture risk. However, more studies are needed to determine whether these new insulins reduce risk of fractures.

Association of blood glucose level and prognosis of inpatients with coexistent diabetes and COVID-19.

Type 2 diabetes (T2D) increases the risk of coronavirus disease (COVID-19). This study investigates the association between glucose control of COVID-19 patients with T2D in first 7 days after hospital admission and prognosis. A total of 252 infected inpatients with T2D in China were included. Well-controlled blood glucose was defined as stable fasting blood glucose (FBG) levels in the range of 3.9–7.8 mmol/L during first 7 days using indicators of average (FBGA), maximum (FBGM) or first-time (FBG1) FBG levels. The primary endpoint was admission to intensive care unit or death. Hazard ratio (HR) of poorly controlled glucose level group compared with well-controlled group were 4.96 (P = 0.021) for FBGM and 5.55 (P = 0.014) for FBGA. Well-controlled blood glucose levels in first 7 days could improve the prognosis of COVID-19 inpatients with diabetes.

Facile Fabrication of Stable Enzyme-Based Colorimetric Glucose Biosensor on Cotton Using Polymer Entrapment

Easy and rapid analyte detection can be democratised using fabric-based colorimetric sensor, which can be readily incorporated into everyday clothing or accessories, and digitally imaged by non-expert users using pervasive smartphones. However, fabricating colorimetric arrays, particularly enzyme-based sensors, on fabrics is nontrivial because enzyme activity cannot be guaranteed upon solid-state immobilisation on textiles, and because textiles present a highly-textured surface that could cause interference during digital imaging and reduce the limit of detection of known sensing formulations. Here, an enzyme-based multilayer sensor is fabricated on selected fabrics via physical adsorption and drop-casting, and utilised for proof-of-concept colorimetric detection of glucose on textiles. Substrates like cotton, cotton lycra, and filter paper are compared for colour uniformity and potential interference during digital imaging. Colour development on cotton achieved optimal homogeneity and reproducibility. The entrapment of enzymes with polyvinyl alcohol is demonstrated to enhance linear dynamic range, water fastness, and storage stability under different conditions. An image-processing algorithm is developed in OpenCV to automatically detect the colour spot and aid in quantitative analysis of glucose concentration. The present study suggests a facile strategy to fabricate a robust biosensor on textile that can achieve noninvasive monitoring of glucose in human biological fluid.

The positive effects of taurine on growth performance, immunohaematological parameters and stress response of farmed beluga ( Huso huso ) in both fresh water and brackish water

Taurine is one of the most studied amino acids in aquaculture over the last decade. This study was conducted to investigate the taurine requirements in terms of growth, immune system, antioxidant enzyme activities and stress response of beluga (Huso huso) (209.1 ± 23 g) in both fresh water (FW) and brackish water (BW: 15 ppt). Twelve experimental tanks with six taurine levels (2.1 g/kg_21.8 g/kg), for FW (Tau2.1, Tau4.3, Tau7.1, Tau12.3, Tau16.7 and Tau21.8) and BW (BwTau2.1, BwTau4.3, BwTau7.1, BwTau12.3, BwTau16.7, and BwTau21.8), were designed to feed and farm fish for eight weeks. Generally, fish farmed in BW had better growth and immune response performance compared with FW. The quadratic relations for pooled data determined taurine requirements in terms of weight gain (12.1 g/kg), lysozyme (13.5 g/kg), IgM (12.7 g/kg) and osmolality (15.1 g/kg) (p<0.05). Furthermore, taurine requirements to obtain the minimum cortisol before and after stress were 10.4 g/kg and 14.3 g/kg, respectively. When we exposed fish to high stock density stress (12 kg/m3 for 4 hours), those fed dietary 16.7 and 21.8 g/kg had more stable glucose, cortisol and lactate before and after stress in both FW and BW. In conclusion, beluga fed diets with 12.3 g/kg and 16.7 g/kg taurine in both FW and BW groups had the best performance regarding growth and health status, respectively.

Effects of BTI320 on Glycemic Control in Patients with Type 2 Diabetes

Background/Purpose: Treatment of Type 2 diabetes (T2D) remains an unmet need, particularly a medication with low toxicity. BTI320 (SugarDown®) is fractionated galactomannan with inhibitory activity on carbohydratehydrolyzing enzymes. The primary objective of this study was to investigate the efficacy and safety of BTI320 on glycemic control in T2D. Subjects/Methods: This was a double-blind, placebo-controlled, multi-center study in 60 T2D adults. Subjects ingested 4 g BTI320 or placebo 10 minutes before meals 3 times daily for 12 weeks. The primary endpoint was the change from Baseline to Week 12 in 2-hr post-prandial glucose (PPG) AUC between groups. Results/Conclusion: A consistent trend was observed in favor of BTI320 vs. placebo in change from Baseline at Week 12 in 2-hr PPG AUC (-795.00 vs. -228.75 mg/dL*min), HbA1c (-0.7% vs. +1.1%), lipids, weight/BMI, and blood pressure. At Week 12, BTI320 had more subjects with stable glucose levels (84.6% vs. 79.2%). According to CGM, the BTI320 group had more subjects with stable glucose levels (84.6 vs. 79.2%) and BTI320 subjects experienced relative hypoglycemia for shorter duration than placebo consistently across all visits. No differences were observed in AE profiles between groups. BTI320 was proven to be efficacious and safe in T2D. This study is registered at ClinicalTrials.gov (NCT03655535).

Self-Assembled Fabrication of Water-Soluble Porphyrin Mediated Supramolecule-Gold Nanoparticle Networks and Their Application in Selective Sensing

Abstract Herein, we report a self-assembled fabrication of a network nanozyme (TMPyP-pSC4@GNPs) and a glucose-recognition molecule (APBA) for highly stable and selective glucose sensing. By involving the derivative of water-soluble porphyrin in TMPyP-pSC4@GNPs, the peroxidase-like catalytic performance of the nanozyme was improved benefiting from the topological structure via high electronic transfer and large surface area. Besides, the hybrid of APBA in TMPyP-pSC4@GNPs can increase the selectivity due to its specific binding affinity with glucose, and the detection signal was enhanced by 73.2%. The excellent stability and selectivity meet the need of clinically detecting glucose in urine and blood. Therefore, this mechanistically novel strategy expands the scope of the traditional GNPs-based catalytic strategy of glucose and serves as an alternative and potential glucose detection platform.

Covalent Immobilisation of a Nanoporous Platinum Film onto a Gold Screen-Printed Electrode for Highly Stable and Selective Non-Enzymatic Glucose Sensing

Progress in the development of commercially available non-enzymatic glucose sensors continues to be problematic due to issues regarding selectivity, reproducibility and stability. Overcoming these issues is a research challenge of significant importance. This study reports a novel fabrication process using a double-layer self-assembly of (3 mercaptopropyl)trimethoxysilane (MPTS) on a gold substrate and co-deposition of a platinum–copper alloy. The subsequent electrochemical dealloying of the less noble copper resulted in a nanoporous platinum structure on the uppermost exposed thiol groups. Amperometric responses at 0.4 V vs. Ag/AgCl found the modification to be highly selective towards glucose in the presence of known interferants. The sensor propagated a rapid response time &lt;5 s and exhibited a wide linear range from 1 mM to 18 mM. Additionally, extremely robust stability was attributed to enhanced attachment due to the strong chemisorption between the gold substrate and the exposed thiol of MPTS. Incorporation of metallic nanomaterials using the self-assembly approach was demonstrated to provide a more reproducible and controlled molecular architecture for sensor fabrication. The successful application of the sensor in real blood serum samples displayed a strong correlation with clinically obtained glucose levels.

Recent Advances in Non-Enzymatic Glucose Sensors Based on Metal and Metal Oxide Nanostructures for Diabetes Management- A Review.

There is an undeniable growing number of diabetes cases worldwide that have received widespread global attention by many pharmaceutical and clinical industries to develop better functioning glucose sensing devices. This has called for an unprecedented demand to develop highly efficient, stable, selective, and sensitive non-enzymatic glucose sensors (NEGS). Interestingly, many novel materials have shown the promising potential of directly detecting glucose in the blood and fluids. This review exclusively encompasses the electrochemical detection of glucose and its mechanism based on various metal-based materials such as cobalt (Co), nickel (Ni), zinc (Zn), copper (Cu), iron (Fe), manganese (Mn), titanium (Ti), iridium (Ir), and rhodium (Rh). Multiple aspects of these metals and their oxides were explored vis-à-vis their performance in glucose detection. The direct glucose oxidation via metallic redox centres is explained by the chemisorption model and the incipient hydrous oxide/adatom mediator (IHOAM) model. The glucose electrooxidation reactions on the electrode surface were elucidated by equations. Furthermore, it was explored that an effective detection of glucose depends on the aspect ratio, surface morphology, active sites, structures, and catalytic activity of nanomaterials, which plays an indispensable role in designing efficient NEGS. The challenges and possible solutions for advancing NEGS have been summarized.

"Two-in-one" portable strategy for non-GOx glucose monitoring: Electrochromic and fluorescent assay using reversible hydrogel

The detection of glucose is important in clinic diagnosis, while the traditional methods for glucose sensing rely heavily on glucose oxidase (GOx). Herein, with the easy preparation, stability as well as selectivity, a polyvinyl borate (PVB) hydrogel was used for the non-GOx and portable detection of glucose. In the colorimetric channel, the hydrogel can be specifically decomposed in the presence of glucose, thus the electric resistance can be changed, causing significant color change of the electrochromic Prussian blue (PB) film in a very short time of 3 s. A linear relationship between the grayscale value of PB and glucose concentration was established in the range between 0.1 and 10.0 mM with the limit of detection (LOD) of 0.02 mM. In addition, the alkaline phosphatase (ALP) in the PVB gel was released to react with L-ascorbyl-2-phosphate, thus the product of ascorbic acid can reduce HAuCl4 to form the aggregation-induced emission enhancement (AIEE) of Au nanoclusters. Two separate ranges with glucose concentrations of 0.1–1.0 mM and 1.0–10.0 mM, and also a LOD of 0.018 mM were achieved. In particular, a mobile APP was designed to read the grayscale values of PB, making the sensor suitable for the on-site detection. Overall, this work may show a great potential in low-cost, stable and portable glucose detection.

ASSESSMENT OF THE POSSIBLE CAUSES OF DIABETES MELLITUS DEVELOPED IN PATIENTS POST COVID-19 TREATMENT IN A TERTIARY CARE HOSPITAL

Objective: Novel COVID-19 virus is extensively being studied for its long-term effects. A predominant trend of development of Diabetes Mellitus (DM) in Covid-19 patients is being observed, and hence further relation is explored in this study. Methods: This is an observational inductive retrospective study conducted for four months in a tertiary care hospital. The study included subjects who recovered from COVID-19 and were treated post-COVID-19 in the hospital. The subjects who had stable glucose counts were excluded. The data obtained from the medical record department encompassed demographic details and clinical data of the patient. The data were tabulated, and observations were reported using descriptive analysis. Results: Among 5632 admitted patients for COVID-19, 694 came for follow-up. 105 patients were re-admitted, but 11 had newly developed DM, and 14 observed uncontrolled DM managed by medical attention. The reported incidence rate in Newly-Diagnosed DM was 0.195%, and the person above 41 y was at greater risk. Similarly, the incidence rate in Uncontrolled-DM was 13.33%, and persons above 47 y were at greater risk. It was found that both these categories of patients had comorbidities, and the development of this was seen between the 25th-40th day. In both cases, males were more prone than females. Conclusion: The study reports a bi-directional relationship between Covid-19 and DM. The use of steroids may have stepped-up this relationship. Cautious use of steroids, changes in the hospital formulary, and further quantitative clinical investigations are primary recommendations that may prevent such episodes.

Expression and Characterization of a Potent Long-Acting GLP-1 Receptor Like Agonist, Exendin-4-Fc

Human GLP-1 (glucagon-like peptide-1) can produce a remarkable improvement in glycemic control in patients with type 2 diabetes. However, its clinical benefits are limited by its short half-life, which is less than 2 min because of its small size and rapid enzymatic inactivation by dipeptidyl peptidase IV. We engineered Exendin-4-Fc, a 66-kDa fusion protein by linking an IgG2 Fc to Exendin-4. A stably transfected Chinese hamster ovary cell line was obtained using electroporation. Exendin-4-Fc stimulated insulin secretion in INS-1 cells in a dose- and glucose-dependent manner and increased insulin mRNA expression. The plasma half-life of Exendin-4-Fc in cynomolgus monkeys was approximately 133.92 ± 25.1 h. In the KKAy mouse model of diabetes, one intraperitoneal injection of Exendin-4-Fc (1 mg/kg) reduced blood glucose levels for 5 days. A 4-week repeat-administration study identified sustained effects on blood glucose levels. Oral glucose tolerance tests conducted at the beginning and end of this 4-week period showed that Exendin-4-Fc produced a stable glucose lowering effect. In addition, KKAy mice treated with Exendin-4-Fc showed statistically significant weight loss from day 23. In conclusion, these properties of Exendin-4-Fc demonstrated that it could be a potential long-acting GLP-1 receptor agonist for the treatment of type 2 diabetes.

A long-term stable and flexible glucose sensor coated with poly(ethylene glycol)-modified polyurethane

• A flexible glucose sensor with long service life and good consistency is proposed. • GOx is coated on the electrode surface by a self-developed electrospray apparatus. • PU surface is modified by chemical grafting to improve its biocompatibility. Flexible biosensors have the great potential to be applied in medical diagnosis, wearable devices, fermentation and other fields. This paper proposes a manufacturing scheme of a flexible enzymatic glucose sensor coated with polyurethane modified by poly(ethylene glycol), PU-PEG, as a protective membrane, which can overcome the problems of poor consistency and short service life of the electrochemical sensor. A platinum-black electrode formed by electroplating platinum-black nanoparticles onto a flexible gold electrode is used as an enzyme carrier. The enzyme is electrosprayed evenly onto the electrode to avoid aggregation and to control quality. Glutaraldehyde is used as a cross-linking agent to immobilise the enzyme layer. Additionally, using PU-PEG as the protective membrane improves the anti-interference performance, controls the enzymatic reaction rate and makes long-term stable operation of the sensor possible. The experimental results show that the linear range of the sensor is 0.5 ~ 25 mM, the minimum detection limit is 0.25 mM, and the sensitivity is as high as 3.418 μA/mM. The measurement results of the sensors show good consistency, with a maximum absolute deviation of only 5.52%. The effective working time in 37℃ bovine serum with a glucose concentration of 5 mM is up to 23 days.

Subcutaneous Adipose Tissue Metabolic Function and Insulin Sensitivity in People With Obesity.

We used stable isotope-labeled glucose and palmitate tracer infusions, a hyperinsulinemic-euglycemic clamp, positron emission tomography of muscles and adipose tissue after [18F]fluorodeoxyglucose and [15O]water injections, and subcutaneous adipose tissue (SAT) biopsy to test the hypotheses that 1) increased glucose uptake in SAT is responsible for high insulin-stimulated whole-body glucose uptake in people with obesity who are insulin sensitive and 2) putative SAT factors thought to cause insulin resistance are present in people with obesity who are insulin resistant but not in those who are insulin sensitive. We found that high insulin-stimulated whole-body glucose uptake in insulin-sensitive participants with obesity was not due to channeling of glucose into SAT but, rather, was due to high insulin-stimulated muscle glucose uptake. Furthermore, insulin-stimulated muscle glucose uptake was not different between insulin-sensitive obese and lean participants even though adipocytes were larger, SAT perfusion and oxygenation were lower, and markers of SAT inflammation, fatty acid appearance in plasma in relation to fat-free mass, and plasma fatty acid concentration were higher in the insulin-sensitive obese than in lean participants. In addition, we observed only marginal or no differences in adipocyte size, SAT perfusion and oxygenation, and markers of SAT inflammation between insulin-resistant and insulin-sensitive obese participants. Plasma fatty acid concentration was also not different between insulin-sensitive and insulin-resistant obese participants, even though SAT was resistant to the inhibitory effect of insulin on lipolysis in the insulin-resistant obese group. These data suggest that several putative SAT factors commonly implicated in causing insulin resistance are normal consequences of SAT expansion unrelated to insulin resistance.

Recent Advances in Enzymatic and Non-Enzymatic Electrochemical Glucose Sensing.

The detection of glucose is crucial in the management of diabetes and other medical conditions but also crucial in a wide range of industries such as food and beverages. The development of glucose sensors in the past century has allowed diabetic patients to effectively manage their disease and has saved lives. First-generation glucose sensors have considerable limitations in sensitivity and selectivity which has spurred the development of more advanced approaches for both the medical and industrial sectors. The wide range of application areas has resulted in a range of materials and fabrication techniques to produce novel glucose sensors that have higher sensitivity and selectivity, lower cost, and are simpler to use. A major focus has been on the development of enzymatic electrochemical sensors, typically using glucose oxidase. However, non-enzymatic approaches using direct electrochemistry of glucose on noble metals are now a viable approach in glucose biosensor design. This review discusses the mechanisms of electrochemical glucose sensing with a focus on the different generations of enzymatic-based sensors, their recent advances, and provides an overview of the next generation of non-enzymatic sensors. Advancements in manufacturing techniques and materials are key in propelling the field of glucose sensing, however, significant limitations remain which are highlighted in this review and requires addressing to obtain a more stable, sensitive, selective, cost efficient, and real-time glucose sensor.

Biomimetic magnetite/polydopamine/β-cyclodextrins nanocomposite for long-term glucose measurements

A highly selective, sensitive, and long-term stable glucose biosensor was developed, based on β-cyclodextrins (β-CDs) grafted onto magnetite/polydopamine (Fe3O4/PDA) with adsorbed glucose oxidase (GOx) from Aspergillus niger. The properties of the nanoplatform were determined by transmission electron microscopy (TEM), atomic force microscopy (AFM), Fourier transform infrared spectroscopy (FT-IR), Bradford assay, electrokinetic analysis (zeta potential), non-invasive light scattering (NIBS) and measurement of the polydispersity index (PdI). The biosensor’s operating conditions were optimized, and the optimal conditions were used in tests on model and real glucose solution. Results for the biosensor showed a broad linear range (1–26 mM glucose), with sensitivity as high as 115.74 μA mM−1 cm−2 and a limit of detection (LOD) of 1.55 μM. The results show the biosensor to be an interesting potential tool for use in many areas where glucose measurement is essential. Moreover, the proposed system demonstrated long-term stability, up to 9 months. Furthermore, excellent selectivity against ascorbic acid, uric acid, L-cysteine and sugars such as saccharose, maltose and fructose was confirmed.

PM Level and Large Dynamic Range Glucose Detection Based on a Sandwich Type Plasmonic Fiber Sensor

A sandwich type titled fiber Bragg grating (TFBG) plasmonic sensor based on self-assembled p-mercaptophenylboronic acid (PMBA) monolayer and Au nanoparticles (AuNPs), has been demonstrated and successfully applied for sensitive and stable low-concentration glucose detection. The sensor was immobilized with PMBA monolayer acting as the highly sensitive and stable glucose recognition molecule instead of a traditional unstable enzyme. In the experiments, the high sensitivity for glucose detection is achieved, establishing a competitive limit of detection (LOD) of 295 pM and large dynamic measurement range from 1 nM to 10 mM simultaneously. Moreover, due to the unique two-set diol configurations of glucose, the combination of TFBG-SPR with AuNPs and PMBA exhibit a good selectivity over fructose and galactose, which both possess only one set of diol configurations. Non-invasive saliva glucose detection, as a better alternative to blood, has emerged and attracted many researchers' attention. Therefore, the practicality of this method was successfully validated by detecting glucose in a simulated human saliva sample. We believe that this method represents an appealing solution for flexible, temperature-insensitive, high-sensitivity, and high-stability detection of ultra-low concentration glucose in modern non-invasive point-of-care testing as well as tumor micro-environment (TME) related cancer research.

Beta-klotho in type 2 diabetes mellitus: From pathophysiology to therapeutic strategies.

Type 2 diabetes mellitus (T2DM) has become a global health problem with no cure. Despite lifestyle modifications and various pharmaceutical options, the achievement of stable and durable glucose control along with effective prevention of T2DM-related cardiovascular complications remains a challenging task in clinical management. With its selective high abundance in metabolic tissues (adipose tissue, liver, and pancreas), β-Klotho is the essential component of fibroblast growth factor (FGF) receptor complexes. It is essential for high-affinity binding of endocrine FGF19 and FGF21 to evoke the signaling cascade actively involved in homeostatic maintenance of glucose metabolism and energy expenditure. In this Review, we discuss the biological function of β-Klotho in the regulation of glucose metabolism and offer mechanistic insights into its involvement in the pathophysiology of T2DM. We review our current understanding of the endocrine axis comprised of β-Klotho and FGFs (FGF19 and FGF21) and its regulatory effects on glucose metabolism under physiological and T2DM conditions. We also highlight advances in the development and preclinical validation of pharmacological compounds that target β-Klotho and/or the β-Klotho-FGFRs complex for the treatment of T2DM. Given the remarkable advances in this field, we also discuss outstanding research questions and the many challenges in the clinical development of β-Klotho-based therapies.

Satisfactory Control for Glucose Profile by Combined Agents of Xultophy with A Small Dose

The patient was a 74-year-old female with type 2 diabetes mellitus (T2DM) treated on Humalog mix 25 twice a day. As social history, she has worked long years for growing and harvesting lotus roots. It gives physically heavy loading, which brings unstable glycemic daily control. She had to titrate minute regulation every time. For stable glucose variability, the treatment was changed to Xultophy, which is a specific combined agent of Insulin Degludec and Liraglutide (IDeg/Lira) once a day. Then, detailed glucose monitoring showed a better daily profile of blood glucose, irrespective of heavy or light work. It showed the bio-psycho-social benefit of Xultophy.

Continuous optical in-line glucose monitoring and control in CHO cultures contributes to enhanced metabolic efficiency while maintaining darbepoetin alfa product quality.

Great efforts are directed towards improving productivity, consistency and quality of biopharmaceutical processes and products. One particular area is the development of new sensors for continuous monitoring of critical bioprocess parameters by using online or in-line monitoring systems. Recently, we developed a glucose biosensor applicable in single-use, in-line and long-term glucose monitoring in mammalian cell bioreactors. Now, we integrated this sensor in an automated glucose monitoring and feeding system capable of maintaining stable glucose levels, even at very low concentrations. We compared this fed-batch feedback system at both low (<1mM) and high (40mM) glucose levels with traditional batch culture methods, focusing on glycosylation and glycation of the recombinant protein darbepoetin alfa (DPO) produced by a CHO cell line. We evaluated cell growth, metabolite and product concentration under different glucose feeding strategies and show that continuous feeding, even at low glucose levels, has no harmful effects on DPO quantity and quality. We conclude that our system is capable of tight glucose level control throughout extended bioprocesses and has the potential to improve performance where constant maintenance of glucose levels is critical.

735-P: Effects of Insulin Degludec in Patients with Diabetes Using Continuous Glucose Monitoring: A Scoping Review

Background: The ultra-long-acting insulin degludec (Deg) was reported to have more stable glucose lowering effect with lower risk of hypoglycemia. This review aimed to summarize data on efficacy and safety of Deg in patients with T1DM or T2DM using continuous glucose monitoring (CGM). Methods: A systematic literature search of studies on Deg in PubMed, EMBASE and Web of Science was performed for articles published before January 2021. Studies reporting data on the efficacy and safety of Deg in patients with diabetes using CGM were included. Results: Thirteen studies with CGM data in 262 patients with T1DM or T2DM were included. The studies were conducted in Japan (11 studies) and Italy (2 studies). Eleven studies focused on patients with T1D (n=208) and two studies on T2D (n=54). The studies compared Deg with insulin glargine 100U/mL (n=130), insulin glargine 300U/mL (n=100), or insulin detemir (n=32). Regarding the study design, six studies were cross-over and seven studies were switching from other basal insulin to Deg. The sample sizes ranged from 7 to 46. The duration of Deg treatment varied between 3 days to 24 weeks. Three studies reported significant improvement of within-day or between-day glycemic variability by Deg, while the other ten studies revealed no difference in glycemic variability. The glucose lowering effect of Deg was comparable to other basal insulin in eleven studies, while two studies found that Deg could further improve glycemic control. Total daily insulin dose reduced in seven studies switching to Deg, while the insulin dose remained unchanged in six studies. In two studies, Deg reduced hypoglycemia when compared with glargine 100U/mL or detemir, which was not observed in other eight studies. However, three studies showed higher percentage time of hypoglycemia with Deg than glargine 300U/mL. Conclusion: Deg leads to similarly effective, stable and safe glycemic control with comparable insulin dose requirement to other basal insulin on the current evidence. Disclosure C. Wang: None. W. Xu: None. X. Yang: None. J. Yan: None. D. Yang: None. B. Yao: None. J. Weng: None. Funding Johnson &amp; Johnson Medical Devices Companies; Novo Nordisk (to J.W.)