Trabalhos Aprovados

Lower day-to-day fasting self-measured plasma glucose (SMPG) variability with insulin degludec/liraglutide (IDegLira) vs. insulin glargine 100 units/mL (IGlar U100)



Autor(es): Rodrigues GP; Lingvay I; Doshi A; Hernandez PG; Torres JFM; Rodacki M; Eggert S; Grøn R; Jaeckel E;
Apresentador(a): Giulliana Parisi Rodrigiues

Introduction: In DUAL V, use of IDegLira resulted in a significantly greater reduction in HbA1c and a 57% lower rate of hypoglycemia versus continued up-titration of IGlar U100. In DUAL VII, IDegLira resulted in a non-inferior reduction in HbA1c and an 89% lower rate of hypoglycemia versus a basal–bolus therapy of IGlar U100 and insulin aspart (IAsp) ≤4 times a day. Aim: This post-hoc analysis aimed to compare day-to-day fasting glycemic variability with IDegLira versus IGlar U100 and IDegLira versus IGlar U100 and IAsp and explore the link between glucose variability and hypoglycemia. Methods: DUAL V and DUAL VII included subjects uncontrolled on basal insulin and adopted a treat-to-target approach to titrate trial products based on daily SMPG measurements. To compare the day-to-day fasting glycemic variability, we used two measures of variability, both based on the daily SMPG values collected in connection with titration in DUAL V and DUAL VII. The daily SMPG values were log-transformed and for each week, the variance of the log-transformed daily SMPG values calculated. The standard deviation of the weekly glycemic variability was then used to calculate an overall glycemic variability measure for each subject. Results: In DUAL V and VII, statistical analyses of the weekly glycemic variability across the 26 weeks of treatment showed a statistically significant lower day-to-day fasting glycemic variability with IDegLira treatment. In DUAL V and VII more subjects treated with IDegLira had lower overall glycemic variability when compared with IGlar U100 or basal–bolus, respectively. The odds of subjects having a lower overall glycemic variability compared with overall glycemic higher variability was statistically significantly greater for IDegLira versus IGlar U100 and with IDegLira versus basal–bolus. The rate of hypoglycemia was numerically lower in the IDegLira group compared with IGlar U100 and basal–bolus therapy across all overall glycemic variability tertiles. Discussion: A higher number of subjects treated with IDegLira had ‘low’ or ‘medium’ overall glycemic variability compared with IGlar U100 or basal–bolus treatment, which may have contributed to the lower rate of hypoglycemia with IDegLira compared with IGlar U100 in DUAL V and basal–bolus treatment in DUAL VII. Conclusion: Based on fasting SMPG values, there was lower day-to-day fasting glycemic variability with IDegLira compared with IGlar U100 up-titration or basal–bolus therapy.

Palavras-chave: DUAL; VARIABILITY; IDEGLIRA

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