Efficacy of switching from basal-bolus insulin therapy to twice-daily insulin degludec/insulin aspart co-formulation plus insulin aspart in patients with poorly controlled type 2 diabetes

OBJECTIVE: The aim of this study was to evaluate the efficacy of twice -daily (BID) insulin degludec/insulin aspart (IDegAsp) co-formulation + once-daily (OD) bolus insulin aspart (IAsp) injection (IDegAsp BID Plus) as simplified intensive insulin therapy in patients with poorly controlled type 2 diabetes mellitus (T2DM) with basal-bolus insulin therapy (BBIT).PATIENTS AND METHODS: The retrospective study included 155 patients who switched from BBIT to IDegAsp BID-Plus. After the initiation of the treatment, 73 patients continued regular follow-up and insulin doses, number of injections, hemoglobin A1c (HbA1c) levels, and other parameters were recorded from their files at baseline, 24, and 52 weeks.RESULTS: The mean age of the study population was 54.3 & PLUSMN;10.2 years, the duration of T2DM was 9.7 & PLUSMN;5.7 years, fasting plasma glucose (FPG) was 252.7 & PLUSMN;66.7 mg/dl, and HbA1c levels were 10.5 & PLUSMN;1.5%. Among the included patients, 15 patients received five injections, 51 patients received four injections, and 7 patients received three injections per day. There was a significant decrease in HbA1c (respectively; 10.46 & PLUSMN;1.54%, 7.97 & PLUSMN;1.24%, 7.98 & PLUSMN;1.23%, baseline and 6th-month p<0.001, baseline and 12th-month p<0.001), FPG (respectively; 251.6 & PLUSMN;66.5 mg/dl, 136.1 & PLUSMN;34.7 mg/ dl, 125.4 & PLUSMN;67.0 mg/dl, baseline and 6th-month p<0.001, baseline and 12th-month p<0.001) and daily dose of insulin (respectively; 102.9 & PLUSMN;29.0 Unit, 73.2 & PLUSMN;18.2 U, 63.7 & PLUSMN;20.3 Unit, baseline and 6th-month p<0.001, baseline and 12th-month p<0.001) at the end of week 24 and 52.CONCLUSIONS: Based on real-world data, this study demonstrated that IDegAsp BID-Plus treatment provides rapid and sustainable blood glucose control with lower insulin doses and fewer injections than previous intensive insulin therapy.