Insulin Degludec Versus Insulin Glargine in Insulin-Naïve Patients With Type 2 Diabetes: A 1-Year, Randomized, Treat-To-Target Trial (BEGIN Once Long)
What is the problem and what is known about it so far?
All people with type 1 diabetes and some with type 2 diabetes need insulin to stay healthy. The introduction of long-acting insulins made taking the medication easier, requiring only a once-daily injection. However, the available insulins are not ideal—wearing off too soon or causing low blood glucose—so scientists continue to develop new insulins that behave more like the insulin produced by the pancreas.
Why did the researchers do this particular study?
The researchers wanted to compare insulin degludec, an ultra-long-acting insulin, with the popular insulin glargine for efficacy and safety.
Who was studied?
The study included 1,030 people with type 2 diabetes with poorly controlled blood glucose (average A1C at the start of the study was 8.2%), but who had never taken insulin before.
How was the study done?
Three-quarters of the participants took insulin degludec each day for a year, while the rest took insulin glargine. Researchers tracked the participants A1C levels and incidence of low blood glucose during the study.
What did the researchers find?
Both insulin glargine and insulin degludec lowered the groups’ A1Cs by about 1 percent. Overall hypoglycemia was roughly the same between the groups, but insulin degludec was associated with less hypoglycemia overnight.
What were the limitations of the study?
Hypoglycemia may be underreported in this study because the participants self-reported the episodes and may have missed some.
What are the implications of the study?
Insulin degludec may work as well as insulin glargine in lowering blood glucose and may be desirable to people concerned with hypoglycemia during the night. Nighttime hypoglycemia is of particular concern because people may not wake up to treat themselves.
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