Abstract
Lilian Sanhueza
Abstract
In the treatment of diabetes, longer-acting insulins with lower rates of hypoglycemia are sought. Objective: Use of ultralong-acting insulin analog Degludec in type 1 diabetic patients (T1D) previously treated with insulin Glargine U-100. Patients and method: 230 T1D patients were observed during 18 months, average of age 34 years and of diagnosis 14 years, registering clinical, biochemical, hypoglycemic events and insulin requirements (U/kg weight). All in basal - bolus regimen, with insulin Degludec and insulin ultra-fast pre-meals. Degludec adjusted fortnightly. Results: At 3 months, the fasting glycemia decreased from 253 mg/dl (243-270) to 180 mg/dl (172 - 240) (p<0.05); at 6 months at 156 mg/dl (137-180) (p<0.05); at 12 months al 151 mg/dl (50-328) (p<0.001) and at 18 months 150 mg/dl (50-321) (p<0.001). HbA1c, initially of 10.6% (10.3-12.2), decreased after 3 months to 8.7% (8.2-11.1) (p<0.05) to 6 months 8.3% (8.0-9.6) (p<0.05) to 12 months 9,0% (5.9-14.5) (p<0.001), to 18 months 9.0% (5.9-14.6) (p<0.001). The dose of Degludec was 0.5 U/kg weight al 18 months. The hypoglycemias were: at 3 months 14 milds, 4 moderate, 1 severe; at 6 months 8 mild, 2 moderate and none serious; at 12 months 1 mild, and at 18 months did not present hypoglycemic events. Conclusion: Degludec in T1D showed to reduce fasting glycemia and HbA1c, and lower number of hypoglycemia in the follow up.