Pharmacokinetic and Pharmacodynamic Head-to-Head Comparison of Clinical, Equivalent Doses of Insulin Glargine 300 units · mL−1 and Insulin Degludec 100 units · mL−1 in Type 1 Diabetes

• DOI: 10.2337/dc20-1033
• Publication Date: 2020-11-10T20:50:50Z
• Authors: Paola Lucidi; Paola Candeloro; Patrizia Cioli; Anna Marinelli An...; Chiara Pascucci; Angela Gambelunghe; Geremia B. Bolli; Carmine G. Fanelli; Francesca Porcellati
• Keywords: Insulin degludec; Pharmacodynamics

To prove equivalence of individual, clinically titrated basal insulin doses glargine 300 units ⋅ mL-1 (Gla-300) and degludec 100 (Deg-100) under steady state conditions in a single-blind, randomized, crossover study, on the glucose pharmacodynamics (PD) people with type 1 diabetes (T1D).Subjects T1D (N = 22, 11 men, age 44.3 ± 12.4 years, disease duration 25.5 11.7 A1C 7.07 0.63% [53.7 6.9 mmol mL-1], BMI 22.5 2.7 kg · m-2), naïve to Gla-300 Deg-100, underwent 24-h euglycemic clamps individual clinical (0.34 0.08 kg-1) Deg-100 (0.26 0.06 kg-1), dosing at 2000 h, after 3 months optimal titration (and bolus) insulin.At end months, reduced slightly and, similarly, versus baseline. Clamp average plasma (0-24 h) was both insulins. The area curve infused (AUC-GIR[0-24 h]) equivalent for two insulins (ratio 1.04, 90% CI 0.91-1.18). Suppression endogenous production, free fatty acids, glycerol, β-hydroxybutyrate 9%, 14%, 18% greater, respectively, compared during first 12 while glucagon suppression no different. Relative within-day PD variability 23% lower 0.77, 0.63-0.92).In T1D, individualized, result similar glycemic control clamps. Clinical are higher associated quite even distribution antilipolytic effects.