This article is more than 5 years old. Information may no longer be current.
Neither duration of diabetes nor BMI seems to impact the ability to reach target HbA1c levels with insulin degludec
Click Here to Manage Email Alerts
PHILADELPHIA — Neither duration of diabetes nor BMI seemed to affect patients’ ability to reach target HbA1C goals after treatment with once-daily insulin degludec, according to data presented by Lawrence Blonde, MD, FACP, FACE, at the American Association of Clinical Endocrinologists 21st Annual Scientific and Clinical Congress.
According to Blonde, who is director of the Ochsner Diabetes Clinical Research Unit, in the Department of Endocrinology, Diabetes, and Metabolism at the Ochsner Medical Center in New Orleans, LA, patients who achieved A1c goals of ≤6.5% or <7% did have lower baseline A1C levels.
The analysis was based on data from three phase 3a trials of patients with type 1 or type 2 diabetes. The objective was to determine whether baseline HbA1c, diabetes duration or BMI differed among insulin degludec-treated individuals who achieved HbA1c ≤ 6.5% or ≤7% compared with individuals who did not achieve these targets.
Trial A included 228 patients with type 2 diabetes who were either previously insulin-naïve or had received prior insulin treatment; they were assigned to once-daily insulin degludec for 26 weeks. Trials B and C included 744 and 472 patients with type 2 or type 1 diabetes, respectively, who were all previously insulin treated; during the trials they received insulin degludec in combination with insulin aspart at mealtime for 52 weeks.
In trial A, among patients who received insulin degludec, 41% achieved HbA1c ≤7% and 23% achieved HbA1c ≤6.5%. In trial B, 49% achieved HbA1c ≤7% and 31% achieved HbA1c ≤6.5%. Lastly, in trial C, 40% achieved HbA1c ≤7% and 24% achieved HbA1c ≤6.5%.
Patients who achieved HbA1c ≤6.5% or ≤7% had lower HbA1c at baseline compared with the total population. Duration of diabetes and BMI were not, however, different among patients who achieved target A1c goals compared with the entire population.
“This evaluation showed that baseline HbA1c, as would be expected, was associated with the ability to reach target, but suggests that neither diabetes duration nor BMI influenced whether A1c targets were achieved with insulin degludec,” Blonde said.
For more information:
Blonde L. Abstract #244. Presented at: the American Association of Clinical Endocrinologists 21st Annual Clinical and Scientific Congress; May 23-27, 2012; Philadelphia.
Disclosure: Two researchers report being employed by NovoNordisk.
Perspective
Back to Top
David S.H. Bell, MD, FACE, FACP
Blonde et al have shown that the higher the HbA1c, the lesser the chance of achieving an HbA1c ≤7%.This information would have been of value to the ACCORD investigators, as the group with highest HbA1c levels in that study were the ones who suffered most from aggressive attempts to lower HbA1c to <6.0%.
Therefore, in the patient with a high A1c with insulin therapy, we should strive to reach an HbA1c between 7.0% and 8.0% based on studies that have shown that mortality, based on HbA1c, is U-shaped with the nadir being 7.5% in a large number of insulin-utilizing UK patients.
Click Here to Manage Email Alerts