05 Jul Newer Insulin Formulation Reduces Risk of Hypoglycemia
MedicalResearch.com Interview with:
Dr. Lane
Wendy Lane MD
Director of Clinical Research
Mountain Diabetes and Endocrine Center
Asheville, NC
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The SWITCH1 trial was the first double blinded insulin trial to compare the rate of severe, nocturnal severe and symptomatic blood glucose-confirmed hypoglycemia between two basal insulins, insulin glargine U100 and insulin degludec U100, in patients with type 1 diabetes.
The trial design (double blinded crossover treat-to-target) eliminated any bias in the results, which showed clear-cut reductions in all categories of hypoglycemia with insulin degludec compared to insulin glargine.
Severe hypoglycemia has dangerous and greatly feared consequences including cognitive impairment, seizures, coma and death, and it is the main barrier to effective use of insulin in the treatment of type 1 diabetes. Insulin degludec, which was shown to reduce the risk of hypoglycemia compared to insulin glargine in the SWITCH1 trial, should be viewed by clinicians as an advancement in insulin therapy which will increase its safety and improve the quality of life of our patients with type 1 diabetes.
MedicalResearch.com: What should clinicians and patients take away from your report?
Response: Although the newer basal insulin analogues, including insulin degludec, are more expensive than older human insulin formulations such as NPH insulin, the reduction in hypoglycemia and improved quality of life afforded by the newer insulin products should compel clinicians to seek the safest treatments, and to find ways to make these newer insulins accessible to our patients, rather than settle for older insulin products simply because they are less expensive.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Future clinical trials examining rates of hypoglycemia with use of different insulin products should include the use of CGM (continuous glucose monitoring), which has become the standard of care in the management of type 1 diabetes. CGM would detect all hypoglycemic episodes, including asymptomatic episodes, which were not captured in the SWITCH1 trial.
Disclosures: I have served on advisory panels and as a speaker for Novo Nordisk, who funded the SWITCH1 trial. I also have received research support from Novo Nordisk, Eli Lilly, and Sanofi Aventis, and have served on advisory panels and as a speaker for Insulet.
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Last Updated on July 5, 2017 by Marie Benz MD FAAD