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Insulin degludec improves glycaemic control with lower nocturnal hypoglycaemia risk than insulin glargine in basal–bolus treatment with mealtime insulin aspart in Type 1 diabetes (BEGIN ® Basal–Bolus Type 1): 2‐year results of a randomized clinical trial
Author(s) -
Bode B. W.,
Buse J. B.,
Fisher M.,
Garg S. K.,
Marre M.,
Merker L.,
Renard E.,
RussellJones D. L.,
Hansen C. T.,
Rana A.,
Heller S. R.
Publication year - 2013
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/dme.12243
Subject(s) - insulin degludec , insulin glargine , medicine , insulin aspart , insulin , endocrinology , diabetes mellitus , type 2 diabetes , basal (medicine) , type 1 diabetes , hypoglycemia
Aims The goal of this study was to compare the long‐term safety and efficacy of the basal insulin analogue, insulin degludec with insulin glargine (both with insulin aspart) in Type 1 diabetes, over a 2‐year time period. Methods This open‐label trial comprised a 1‐year main trial and a 1‐year extension. Patients were randomized to once‐daily insulin degludec or insulin glargine and titrated to pre‐breakfast plasma glucose values of 3.9–4.9 mmol/l. Results The rate of nocturnal confirmed hypoglycaemia was 25% lower with insulin degludec than with insulin glargine ( P = 0.02). Rates of confirmed hypoglycaemia, severe hypoglycaemia and adverse events, and reductions in glycated haemoglobin and fasting plasma glucose were similar between groups. Despite achieving similar glycaemic control, insulin degludec‐treated patients used 12% less basal and 9% less total daily insulin than did insulin glargine‐treated patients ( P < 0.01). Conclusions Long‐term basal therapy using insulin degludec in Type 1 diabetes required lower doses and was associated with a 25% lower risk for nocturnal hypoglycaemia than insulin glargine.