Use of IDegAsp in type 2 diabetes

As pancreatic β-cell function declines in people with type 2 diabetes, insulin treatment may be required, in combination with oral anti-diabetic drugs (OADs), to achieve recommended levels of glycaemic control. Insulin treatment is commonly initiated as a once-daily injection of a basal insulin analogue, or a once- or twice-daily injection of a premixed (biphasic) insulin analogue suspension (containing fixed proportions of a rapid-acting soluble insulin analogue and an intermediate-acting, insoluble, protamine-bound form) that provides both basal and meal-related insulin. Given the substantial contribution of postprandial hyperglycaemia to overall glycaemia, initiating insulin therapy with a combination of rapid- and long-acting insulin in one injection may, for patients where basal insulin alone is inadequate, be a simpler and more convenient approach to achieving and sustaining optimal glycaemic control compared with basal–bolus therapy.

Niskanen et al. conducted a clinical proof-of-concept, treat-to-target trial to investigate the efficacy and safety of insulin initiation with twice-daily administration of IDegAsp, the first soluble combination of distinct rapid-acting and basal insulin analogues, as add-on therapy to metformin in patients with type 2 diabetes inadequately controlled with OAD therapy. IDegAsp was compared with BIAsp 30, a widely used premixed insulin analogue suspension that is often used in a twice-daily treatment regimen when commencing insulin therapy. The results of their study show that IDegAsp is a promising new treatment option for initiating insulin therapy in subjects with type 2 diabetes inadequately controlled with OADs. Twice-daily IDegAsp (in combination with metformin) was safe and well tolerated and provided overall glycaemic control similar to BIAsp 30 at a significantly lower rate of confirmed hypoglycaemia. Niskanen et al. (2012) European Journal of Endocrinology 167 287-294.

Read full article at: DOI 10.1530/EJE-12-0293