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Published Online: 8 August 2024

Continuous Glucose Monitoring-Derived Glucometrics in Adults with Type 1 Diabetes When Switching Basal Insulins

Publication: Diabetes Technology & Therapeutics
Volume 26, Issue Number 8

Abstract

Context: Limited evidence is available on the real-world effect of insulin degludec (IDeg) in type 1 diabetes (T1D), using continuous glucose monitoring (CGM)-derived metrics.
Objective: To assess the real-world effect of switching to IDeg from other long-acting insulins on time in ranges (TIRs) measured by CGM, metabolic control, and insulin dose for people with T1D.
Design: This retrospective multicenter study encompassed five time points during a 12-month pre-switch of IDeg and a 12-month follow-up period. For each visit, clinical and CGM data were collected to evaluate temporal trends in glycemic outcomes.
Participants: Of 753 persons with T1D who were assessed for eligibility, 486 persons were included, mostly men (61.5%), 47.4 (16.9) years old and diabetes duration of 23.8 (14.2) years at IDeg-initiation.
Main Outcome Measure: Primary outcome was the evolution of percent TIR (70–180 mg/dL or 3.9–10.0 mmol/L, TIR) before versus after switch to IDeg.
Results: TIR over 24 h increased at 12 months versus baseline (56.7% vs. 52.3%, P < 0.001), mostly during daytime. Time <54 mg/dL (<3.0 mmol/L) over 24 h decreased at 12 months versus baseline (2.02% vs. 2.86%, P < 0.001), mostly during nighttime. Glycated hemoglobin (7.9% vs. 8.1%, P < 0.001) and coefficient of variation (40.0% vs. 41.5%, P < 0.001) improved at 12 months versus baseline. Mean daily basal, bolus and total insulin doses decreased at 12 months (P < 0.001 for all vs. baseline).
Conclusions: This retrospective real-world study reports that switching basal insulin significantly improved time spent in glucometric ranges and glycemic variability in the studied population of people with T1D.
Clinical Trial Registration number: NCT05434559.

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Published In

cover image Diabetes Technology & Therapeutics
Diabetes Technology & Therapeutics
Volume 26Issue Number 8August 2024
Pages: 587 - 595
PubMed: 38512387

History

Published online: 8 August 2024
Published in print: August 2024
Published ahead of print: 9 April 2024
Published ahead of production: 21 March 2024

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Original data generated and analyzed during this study are included in this published article or in the data repositories listed in References.

Authors

Affiliations

Robbe De Groote
Department of Endocrinology, University Hospitals Leuven—KU Leuven, Leuven, Belgium.
Eveline Lefever*
Department of Endocrinology, University Hospitals Leuven—KU Leuven, Leuven, Belgium.
Department of Endocrinology, University Hospitals Leuven—KU Leuven, Leuven, Belgium.
Phebe Donné
Department of Endocrinology, Diabetology and Metabolism, University of Antwerp—Antwerp University Hospital, Edegem, Belgium.
Department of Endocrinology, Diabetology and Metabolism, University of Antwerp—Antwerp University Hospital, Edegem, Belgium.
Chantal Mathieu
Department of Endocrinology, University Hospitals Leuven—KU Leuven, Leuven, Belgium.
Department of Endocrinology, University Hospitals Leuven—KU Leuven, Leuven, Belgium.
Fonds Wetenschappelijk Onderzoek (FWO), Brussels, Belgium.

Notes

*
Shared first author.
Prior presentation: Parts of results in this manuscript were presented at the 59th Annual Meeting of the European Association for the study of Diabetes, 2 October until 6 October 2023.
Address correspondence to: Pieter Gillard, MD, PhD, Department of Endocrinology, University Hospitals Leuven—KU Leuven, UZ Leuven, Herestraat 49, Leuven 3000, Belgium [email protected]

Authors' Contributions

R.D.G. collected and analyzed data, performed statistical analyses, wrote the manuscript, and made figures and tables. E.L. designed the study, collected the data from University Hospitals Leuven, and wrote the manuscript. S.C. designed the study, collected and discussed the data, made figures, and edited the manuscript. P.D. collected the data from University Hospitals Antwerp, and edited the manuscript. C.D.B. collected, discussed, and edited the manuscript. C.M. and P.G. designed the study, collected, and discussed the data and edited the manuscript. R.D.G., S.C., and P.G. are guarantors of this work and, as such, had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Author Disclosure Statement

KU Leuven has received research support for S.C. from Roche Diabetes Care, Novo Nordisk, and Sanofi. C.D.B. reports consulting fees and honoraria for speaking for Abbott, AstraZeneca, Boehringer-Ingelheim, A. Menarini Diagnostics, Eli Lilly, Medtronic, Novo Nordisk, and Roche. C.M. serves or has served on the advisory panel for Novo Nordisk, Sanofi, Merck Sharp and Dohme Ltd., Eli Lilly and Company, Novartis, AstraZeneca, Boehringer Ingelheim, Roche, Medtronic, ActoBio Therapeutics, Pfizer, Imcyse, Insulet, Zealand Pharma, Avotres, Mannkind, Sandoz and Vertex. Financial compensation for these activities has been received by KU Leuven; KU Leuven has received research support for C.M. from Medtronic, Imcyse, Novo Nordisk, Sanofi, and ActoBio Therapeutics; C.M. serves or has served on the speakers bureau for Novo Nordisk, Sanofi, Eli Lilly and Company, Boehringer Ingelheim, Astra Zeneca, and Novartis. Financial compensation for these activities has been received by KU Leuven. CM is president of EASD. All external support of EASD is to be found on www.easd.org. P.G. serves or has served on the advisory panel for Novo Nordisk, Sanofi-Aventis, Boehringer-Ingelheim, Janssen Pharmaceuticals, Roche, Medtronic, Abbott, and Bayer. Financial compensation for these activities has been received by KU Leuven. P.G. serves or has served on the speakers bureau for Merck Sharp and Dohme, Boehringer-Ingelheim, Bayer, Medtronic, Insulet, Novo Nordisk, Abbott, Roche, VitalAire, and Dexcom. Financial compensation for these activities has been received by KU Leuven. KU Leuven received for P.G. nonfinancial support for travel from Sanofi-Aventis, A. Menarini Diagnostics, Novo Nordisk, Medtronic, and Roche. R.D.G, E.L., and P.D. have nothing to disclose.

Funding Information

Novo Nordisk provided a grant for the current work and reviewed the manuscript, but had no role in study design, data collection, data analysis, data interpretation, writing of the report, or the decision to submit for publication. Recipient: University Hospitals Leuven.

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