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Efficacy and safety of co-formulation insulin: a real world clinical audit


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Abstract Background : Insulin degludec/insulin aspart (IDegAsp) is a co-formulation of the ultra-long-acting insulin degludec (IDeg) and the rapid-acting analog insulin aspart (IAsp) in 70:30 ratio. The individual properties of basal and prandial insulin are preserved in this co-formulation and present an opportunity to correct both fasting and post-prandial glucose with an advantage of single prick and simple regime in type 2 diabetic (T2D) patients (1). Aim: To evaluate the efficacy and safety of co-formulation (IDegAsp) insulin in patients poorly controlled on multiple oral anti-diabetics (OADs). Methods: A retrospective real world observational case note study were conducted in three diabetes care centres in India and the records of insulin naive T2D patients, who were initiated with once daily IDegAsp after multiple (2 or more) OAD failure were analysed. Patients who dropped out before 12 weeks, who required additional prandial insulin support or those without complete dataset, were excluded. Total 83 patients fulfilled the eligibility criterion of analysis (Table-1). Results: Most patients of our cohort was male (63.86%). Mean age and mean BMI of our cohort was 59.49 years and 27.22 respectively (Table-1). Statistical significant improvement in FPG (p <0.001), PPPG (p <0.001) and HbA1c (p <0.001) were observed over an average of 24 weeks follow up, without any significant changes in weight, BMI and serum creatinine value (Table-2). There were 3 events of asymptomatic, 16 events of symptomatic and 5 events of severe hypoglycemia but no event of nocturnal hypoglycaemia. Discussion: The introduction of IDegAsp, in T2D patients with multiple OAD failure, consistently improved all parameters of glucose control. Unlike basal insulin, IDegAsp provides a significant improvement in postprandial glucose excursions also, a distinct advantage with a single prick. Some weight gain is expected with all forms of insulin therapy including IDegAsp (1), but no significant gain in weight (p =0.702) or BMI (p=0.812) was observed in our cohort. Though the total hypoglycaemic events were 28.9 %, only few patients (6%) suffered severe hypoglycaemia. Nocturnal hypoglycaemia, a recognised barrier to treatment intensification for some patients, was absent with IDegAsp in our cohort (2). IDegAsp, the novel pharmaceutical coformulation, offer clinical advantages over currently available insulin preparations.


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© Copyright 2020 Morressier GmbH.
All rights reserved.