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Reduction of glycemic variability with Degludec insulin in patients with unstable diabetes

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dc.contributor.authorHenao-Carrillo, Diana Cristina
dc.contributor.authorMuñoz, Oscar M.
dc.contributor.authorGómez, Ana M.
dc.contributor.authorRondón, Martín
dc.contributor.authorColon Peña, Christian Alejandro
dc.contributor.authorGuillermo Chica, L.
dc.contributor.authorRubio, Claudia
dc.contributor.authorLeón-Vargas, Fabián
dc.contributor.authorCalvachi, Maria Alejandra
dc.contributor.authorPerea, Ana María
dc.contributor.corporatenamePontificia Universidad Javeriana. Facultad de Medicina. Departamento de Medicina Interna. Enfermedades Crónicas del Adulto
dc.contributor.corporatenamePontificia Universidad Javeriana. Facultad de Medicina. Departamento de Epidemiología Clínica y Bioestadística
dc.contributor.corporatenamePontificia Universidad Javeriana. Facultad de Medicina. Hospital Universitario San Ignacio
dc.date.accessioned2020-04-21T11:41:20Z
dc.date.accessioned2020-05-08T15:22:50Z
dc.date.available2020-04-21T11:41:20Z
dc.date.available2020-05-08T15:22:50Z
dc.date.created2018-03-20
dc.description.abstractenglishIntroduction Degludec (IDeg) is an ultralong-acting insulin, with stable pharmacodynamic profile which leads to lower fluctuations in glucose levels. The effect of IDeg has not been specifically assessed in patients with unstable diabetes, defined as increased glycemic variability (GV). Methods A prospective before-after pilot study was conducted, including patients managed at Hospital Universitario San Ignacio in Bogotá, Colombia. The impact of the switch from a Glargine or Detemir insulin to a basal insulin regimen with IDeg for 12 weeks on GV measured by continuous glucose monitoring, on A1c levels, and on the incidence of episodes of global and nocturnal hypoglycemia was assessed in a group of patients with (coefficient of variation >34%) or without increased basal GV using a Generalised Estimating Equation (GEE) analysis. Results 60 patients with basal bolus therapy and history of hypoglycemia were included. 18 patients had High GV (HGV). In this group a significant reduction of 11.1% of CV (95% CI: 6.3, 15.9, p = 0.01) was found. GEE analysis confirmed a higher impact over time on patients with HGV (p < 0.001). The percentage of patients with at least 1 episode of hypoglycemia decreased from 66.6% to 22.2% (p = 0.02) and from 37.14% to 5.71% (p < 0.01) for global and nocturnal hypoglycemia, respectively. Changes were not significant in patients with low GV. A reduction of A1c was observed in both groups (p < 0.001). Conclusions The results suggest that treatment with IDeg reduces GV, A1c levels and the incidence of global and nocturnal hypoglycemia events in patients with HGV, but not in patients with low GV.spa
dc.description.paginas8-12spa
dc.description.quartilescopusQ3spa
dc.description.tipoarticuloArtículo originalspa
dc.formatPDFspa
dc.format.mimetypeapplication/pdfspa
dc.format.soportePapel / Electrónicospa
dc.identifierhttps://www.sciencedirect.com/science/article/pii/S2214623718300206spa
dc.identifier.doihttps://doi.org/10.1016/j.jcte.2018.03.003spa
dc.identifier.issn2214-6237 (Electrónico)spa
dc.identifier.urihttp://hdl.handle.net/10554/48352
dc.languagespaspa
dc.rights.licenceAtribución-NoComercial 4.0 Internacional*
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/*
dc.sourceJournal of Clinical and Translational Endocrinology; Vol. 12 (2018)spa
dc.subject.keywordType 1 diabetesspa
dc.subject.keywordType 2 diabetesspa
dc.subject.keywordGlycemic variabilityspa
dc.subject.keywordInsulin degludecspa
dc.titleReduction of glycemic variability with Degludec insulin in patients with unstable diabetesspa
dc.typeinfo:eu-repo/semantics/article
dc.type.hasversionhttp://purl.org/coar/version/c_ab4af688f83e57aa
dc.type.localArtículo de revistaspa

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