Findings from two new trials published in JAMA have prompted experts to question whether insulin degludec should be recommended over insulin glargine U100 in patients with type 1 and 2 diabetes at risk of hypoglycaemia.
The SWITCH 1 trial, undertaken among 501 adults with type 1 diabetes, and the SWITCH 2 trial, undertaken among 721 adults with type 2 diabetes found treatment with insulin degludec compared to glargine U100 for 32 weeks resulted in a reduced rate of hypoglycaemic episodes among both sets of patients.
Writing in a JAMA editorial , Dr Elizabeth R. Seaquist and Dr Lisa S. Chow noted there are a number of caveats to be considered when interpreting the results including the fact that as the insulin types were titrated using a set protocol that probably exceeds common clinical practice, a more pragmatic trial is warranted. They said however, “given the risks associated with hypoglycaemia and the negative consequences that concerns about hypoglycaemia have for patients and their families, any basal insulin associated with a reduced rate of hypoglycaemia would seem to represent an advance in therapy”.
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