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Degludec is superior to glargine in terms of daily glycemic variability in people with type 1 diabetes mellitus
To investigate the differences in glycemic variability between the long-acting insulins glargine and degludec using continuous glucose monitoring, we conducted an open-label, multicenter, prospective, observational study that enrolled 21 participants with type 1 diabetes mellitus currently receiving...
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| Published in: | Endocrine Journal 2016, Vol.63(1), pp.53-60 |
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| Main Authors: | , , , , , , , , |
| Format: | Article |
| Language: | English |
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| cites | cdi_FETCH-LOGICAL-c542t-5ec2f3973d851c43d08b436e3de844677985b61f4cf798945eab8269663cfb963 |
| container_end_page | 60 |
| container_issue | 1 |
| container_start_page | 53 |
| container_title | Endocrine Journal |
| container_volume | 63 |
| creator | Yamamoto, Chiho Miyoshi, Hideaki Fujiwara, Yutaka Kameda, Reina Ichiyama, Mei Nomoto, Hiroshi Kameda, Hiraku Nakamura, Akinobu Atsumi, Tatsuya |
| description | To investigate the differences in glycemic variability between the long-acting insulins glargine and degludec using continuous glucose monitoring, we conducted an open-label, multicenter, prospective, observational study that enrolled 21 participants with type 1 diabetes mellitus currently receiving basal-bolus insulin therapy with glargine. To avoid the potential influence of diet and exercise on glycemic control, all participants were housed and monitored within the hospital for the duration of the study. Once glycemic control was achieved with glargine, glycemic variability was evaluated using continuous glucose monitoring for 3 days. Glargine was then replaced by degludec and glycemic variability again assessed via continuous glucose monitoring. The primary outcome measure of mean amplitude of glycemic excursions was significantly reduced with degludec (p = 0.028), as was area under the curve for daily blood glucose level |
| doi_str_mv | 10.1507/endocrj.EJ15-0438 |
| format | article |
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To avoid the potential influence of diet and exercise on glycemic control, all participants were housed and monitored within the hospital for the duration of the study. Once glycemic control was achieved with glargine, glycemic variability was evaluated using continuous glucose monitoring for 3 days. Glargine was then replaced by degludec and glycemic variability again assessed via continuous glucose monitoring. The primary outcome measure of mean amplitude of glycemic excursions was significantly reduced with degludec (p = 0.028), as was area under the curve for daily blood glucose level <70 mg/dL (p = 0.046). The required insulin dose was reduced up to 25% in the degludec group, although 24-h mean glucose concentrations were not different between groups. In conclusion, once or twice daily glargine was successfully replaced by a daily injection of degludec. When replacing glargine with degludec, a lower dose should be utilized to avoid hypoglycemia. Degludec is an effective and promising long-acting insulin that reduced hypoglycemia and daily blood glucose variability in participants with type 1 diabetes.</description><identifier>ISSN: 0918-8959</identifier><identifier>EISSN: 1348-4540</identifier><identifier>DOI: 10.1507/endocrj.EJ15-0438</identifier><identifier>PMID: 26522272</identifier><language>eng</language><publisher>Japan: The Japan Endocrine Society</publisher><subject>Adult ; Aged ; Blood Glucose - drug effects ; Blood Glucose - metabolism ; Circadian Rhythm ; Continuous glucose monitoring ; Diabetes Mellitus, Type 1 - blood ; Diabetes Mellitus, Type 1 - complications ; Diabetes Mellitus, Type 1 - drug therapy ; Female ; Humans ; Hypoglycemia - chemically induced ; Insulin degludec ; Insulin Glargine - therapeutic use ; Insulin, Long-Acting - therapeutic use ; Male ; Middle Aged ; Type1 diabetes mellitus</subject><ispartof>Endocrine Journal, 2016, Vol.63(1), pp.53-60</ispartof><rights>The Japan Endocrine Society</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c542t-5ec2f3973d851c43d08b436e3de844677985b61f4cf798945eab8269663cfb963</citedby><cites>FETCH-LOGICAL-c542t-5ec2f3973d851c43d08b436e3de844677985b61f4cf798945eab8269663cfb963</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,1894,4043,27956,27957,27958</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26522272$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yamamoto, Chiho</creatorcontrib><creatorcontrib>Miyoshi, Hideaki</creatorcontrib><creatorcontrib>Fujiwara, Yutaka</creatorcontrib><creatorcontrib>Kameda, Reina</creatorcontrib><creatorcontrib>Ichiyama, Mei</creatorcontrib><creatorcontrib>Nomoto, Hiroshi</creatorcontrib><creatorcontrib>Kameda, Hiraku</creatorcontrib><creatorcontrib>Nakamura, Akinobu</creatorcontrib><creatorcontrib>Atsumi, Tatsuya</creatorcontrib><title>Degludec is superior to glargine in terms of daily glycemic variability in people with type 1 diabetes mellitus</title><title>Endocrine Journal</title><addtitle>Endocr J</addtitle><description>To investigate the differences in glycemic variability between the long-acting insulins glargine and degludec using continuous glucose monitoring, we conducted an open-label, multicenter, prospective, observational study that enrolled 21 participants with type 1 diabetes mellitus currently receiving basal-bolus insulin therapy with glargine. To avoid the potential influence of diet and exercise on glycemic control, all participants were housed and monitored within the hospital for the duration of the study. Once glycemic control was achieved with glargine, glycemic variability was evaluated using continuous glucose monitoring for 3 days. Glargine was then replaced by degludec and glycemic variability again assessed via continuous glucose monitoring. The primary outcome measure of mean amplitude of glycemic excursions was significantly reduced with degludec (p = 0.028), as was area under the curve for daily blood glucose level <70 mg/dL (p = 0.046). The required insulin dose was reduced up to 25% in the degludec group, although 24-h mean glucose concentrations were not different between groups. In conclusion, once or twice daily glargine was successfully replaced by a daily injection of degludec. When replacing glargine with degludec, a lower dose should be utilized to avoid hypoglycemia. Degludec is an effective and promising long-acting insulin that reduced hypoglycemia and daily blood glucose variability in participants with type 1 diabetes.</description><subject>Adult</subject><subject>Aged</subject><subject>Blood Glucose - drug effects</subject><subject>Blood Glucose - metabolism</subject><subject>Circadian Rhythm</subject><subject>Continuous glucose monitoring</subject><subject>Diabetes Mellitus, Type 1 - blood</subject><subject>Diabetes Mellitus, Type 1 - complications</subject><subject>Diabetes Mellitus, Type 1 - drug therapy</subject><subject>Female</subject><subject>Humans</subject><subject>Hypoglycemia - chemically induced</subject><subject>Insulin degludec</subject><subject>Insulin Glargine - therapeutic use</subject><subject>Insulin, Long-Acting - therapeutic use</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Type1 diabetes mellitus</subject><issn>0918-8959</issn><issn>1348-4540</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><recordid>eNo9kE1v1DAQhq0K1G4LP4AL8pFLir_jHFFpS1ElLnC2HGey9SpZB9uhyr-vo11ymRlpnnk1ehD6RMktlaT-CscuuHi4vf9JZUUE1xdoR7nQlZCCvEM70lBd6UY2V-g6pQMhnEvBL9EVU5IxVrMdCt9hP8wdOOwTTvME0YeIc8D7wca9PwL2R5whjgmHHnfWD0tZLQ5G7_A_G71t_eDzsmIThGkA_OrzC87LBJjiruwhQ8IjDAWb0wf0vrdDgo_nfoP-PNz_vvtRPf96fLr79lw5KViuJDjW86bmnZbUCd4R3QqugHeghVB13WjZKtoL15exERJsq5lqlOKubxvFb9CXU-4Uw98ZUjajT648YY8Q5mRorRgXTGpeUHpCXQwpRejNFP1o42IoMatnc_ZsVs9m9VxuPp_j53aEbrv4L7YAjyfgkLLdwwbYmL0bYItU3NC1bNEb4V5sLBh_A05alWo</recordid><startdate>2016</startdate><enddate>2016</enddate><creator>Yamamoto, Chiho</creator><creator>Miyoshi, Hideaki</creator><creator>Fujiwara, Yutaka</creator><creator>Kameda, Reina</creator><creator>Ichiyama, Mei</creator><creator>Nomoto, Hiroshi</creator><creator>Kameda, Hiraku</creator><creator>Nakamura, Akinobu</creator><creator>Atsumi, Tatsuya</creator><general>The Japan Endocrine Society</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>2016</creationdate><title>Degludec is superior to glargine in terms of daily glycemic variability in people with type 1 diabetes mellitus</title><author>Yamamoto, Chiho ; Miyoshi, Hideaki ; Fujiwara, Yutaka ; Kameda, Reina ; Ichiyama, Mei ; Nomoto, Hiroshi ; Kameda, Hiraku ; Nakamura, Akinobu ; Atsumi, Tatsuya</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c542t-5ec2f3973d851c43d08b436e3de844677985b61f4cf798945eab8269663cfb963</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Blood Glucose - drug effects</topic><topic>Blood Glucose - metabolism</topic><topic>Circadian Rhythm</topic><topic>Continuous glucose monitoring</topic><topic>Diabetes Mellitus, Type 1 - blood</topic><topic>Diabetes Mellitus, Type 1 - complications</topic><topic>Diabetes Mellitus, Type 1 - drug therapy</topic><topic>Female</topic><topic>Humans</topic><topic>Hypoglycemia - chemically induced</topic><topic>Insulin degludec</topic><topic>Insulin Glargine - therapeutic use</topic><topic>Insulin, Long-Acting - therapeutic use</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Type1 diabetes mellitus</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yamamoto, Chiho</creatorcontrib><creatorcontrib>Miyoshi, Hideaki</creatorcontrib><creatorcontrib>Fujiwara, Yutaka</creatorcontrib><creatorcontrib>Kameda, Reina</creatorcontrib><creatorcontrib>Ichiyama, Mei</creatorcontrib><creatorcontrib>Nomoto, Hiroshi</creatorcontrib><creatorcontrib>Kameda, Hiraku</creatorcontrib><creatorcontrib>Nakamura, Akinobu</creatorcontrib><creatorcontrib>Atsumi, Tatsuya</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Endocrine Journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yamamoto, Chiho</au><au>Miyoshi, Hideaki</au><au>Fujiwara, Yutaka</au><au>Kameda, Reina</au><au>Ichiyama, Mei</au><au>Nomoto, Hiroshi</au><au>Kameda, Hiraku</au><au>Nakamura, Akinobu</au><au>Atsumi, Tatsuya</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Degludec is superior to glargine in terms of daily glycemic variability in people with type 1 diabetes mellitus</atitle><jtitle>Endocrine Journal</jtitle><addtitle>Endocr J</addtitle><date>2016</date><risdate>2016</risdate><volume>63</volume><issue>1</issue><spage>53</spage><epage>60</epage><pages>53-60</pages><issn>0918-8959</issn><eissn>1348-4540</eissn><notes>ObjectType-Article-2</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-1</notes><notes>content type line 23</notes><notes>ObjectType-Undefined-3</notes><abstract>To investigate the differences in glycemic variability between the long-acting insulins glargine and degludec using continuous glucose monitoring, we conducted an open-label, multicenter, prospective, observational study that enrolled 21 participants with type 1 diabetes mellitus currently receiving basal-bolus insulin therapy with glargine. To avoid the potential influence of diet and exercise on glycemic control, all participants were housed and monitored within the hospital for the duration of the study. Once glycemic control was achieved with glargine, glycemic variability was evaluated using continuous glucose monitoring for 3 days. Glargine was then replaced by degludec and glycemic variability again assessed via continuous glucose monitoring. The primary outcome measure of mean amplitude of glycemic excursions was significantly reduced with degludec (p = 0.028), as was area under the curve for daily blood glucose level <70 mg/dL (p = 0.046). The required insulin dose was reduced up to 25% in the degludec group, although 24-h mean glucose concentrations were not different between groups. In conclusion, once or twice daily glargine was successfully replaced by a daily injection of degludec. When replacing glargine with degludec, a lower dose should be utilized to avoid hypoglycemia. Degludec is an effective and promising long-acting insulin that reduced hypoglycemia and daily blood glucose variability in participants with type 1 diabetes.</abstract><cop>Japan</cop><pub>The Japan Endocrine Society</pub><pmid>26522272</pmid><doi>10.1507/endocrj.EJ15-0438</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Endocrine Journal, 2016, Vol.63(1), pp.53-60 |
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| source | J-STAGE (Japan Science & Technology Information Aggregator, Electronic) - Open Access English articles |
| subjects | Adult Aged Blood Glucose - drug effects Blood Glucose - metabolism Circadian Rhythm Continuous glucose monitoring Diabetes Mellitus, Type 1 - blood Diabetes Mellitus, Type 1 - complications Diabetes Mellitus, Type 1 - drug therapy Female Humans Hypoglycemia - chemically induced Insulin degludec Insulin Glargine - therapeutic use Insulin, Long-Acting - therapeutic use Male Middle Aged Type1 diabetes mellitus |
| title | Degludec is superior to glargine in terms of daily glycemic variability in people with type 1 diabetes mellitus |
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