Glycaemic outcomes in hospital with IDegAsp versus BIAsp30 premixed insulins
Background and Aims IDegAsp (Ryzodeg 70/30), a unique premixed formulation of long‐acting insulin degludec and rapid‐acting insulin aspart, is increasing in use. Management of IDegAsp during hospitalisation is challenging because of degludec's ultra‐long duration of action. We investigated inpa...
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| Published in: | Internal medicine journal Vol. 54; no. 8; pp. 1329 - 1336 |
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| Main Authors: | , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Melbourne
John Wiley & Sons Australia, Ltd
01-08-2024
Wiley Subscription Services, Inc |
| Subjects: | |
| Online Access: | Get full text |
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| Summary: | Background and Aims
IDegAsp (Ryzodeg 70/30), a unique premixed formulation of long‐acting insulin degludec and rapid‐acting insulin aspart, is increasing in use. Management of IDegAsp during hospitalisation is challenging because of degludec's ultra‐long duration of action. We investigated inpatient glycaemia in patients treated with IDegAsp compared to biphasic insulin aspart (BIAsp30; Novomix30).
Methods
We performed a retrospective observational study at two hospitals assessing inpatients with type 2 diabetes treated with IDegAsp or BIAsp30 prior to and during hospital admission. Standard inpatient glycaemic outcomes were analysed based on capillary blood glucose (BG) measurements.
Results
We assessed 88 individuals treated with IDegAsp and 88 HbA1c‐matched individuals treated with BIAsp30. Patient characteristics, including insulin dose at admission, were well matched, but the IDegAsp group had less frequent twice‐daily insulin dosing than the BIAsp30 group (49% vs 87%, P < 0.001). Patient‐days with BG <4 mmol/L were not different (10.6% vs 9.9%, P = 0.7); however, the IDegAsp group had a higher patient‐day mean BG (10.4 (SD 3.4) vs 10.0 (3.4) mmol/L, P < 0.001), and more patient‐days with mean BG >10 mmol/L (48% vs 38%, P < 0.001) compared to the BIAsp30 group. Glucose was higher in the IDegAsp group in the evening (4 PM to midnight) (11.6 (SD 4.0) vs 10.9 (4.6) mmol/L, P = 0.004), but not different at other times during the day.
Conclusions
Inpatients treated with IDegAsp compared to BIAsp30 had similar hypoglycaemia incidence, but higher hyperglycaemia incidence, potentially related to less frequent twice‐daily dosing. With the increasing use of IDegAsp in the community, development of hospital management guidelines for this insulin formulation is needed. |
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| Bibliography: | Conflict of interest: S. Fourlanos has received honoraria for speaker fees for AstraZeneca, Boehringer‐Ingelheim, Lilly and Novo Nordisk and honoraria for advisory fees for Medtronic, Mylan, Pfizer and Sanofi. M. Kyi has received honoraria for speaker fees for AstraZeneca. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3 |
| ISSN: | 1444-0903 1445-5994 1445-5994 |
| DOI: | 10.1111/imj.16391 |