Wang Xinyu, Zhang Yundi, Li Yue, Zong Huiying, Han Wenqian, Liu Lun, Wang Qian, Guo Lubo, Di Huifeng, Zhen Xiaohui, Sun Deqing, Su Ying, Zhang Zonglin, Peng Jing, Cao Xiaofu, Liu Ning, Liu Jian, Lu Cuicui, Wang Li, Geng Tao, Li Rongji, Sun Guodong, Zhang Fan, Zhang Lin, Ma Chuanjiang, Tan Siyuan, Qian Dongfang, Li Yan
Objective To compare the efficacy and safety of insulin degludec and insulin glargine U100 in patients with type 2 diabetes mellitus. Methods This study was a retrospective cohort study. The subjects were patients with type 2 diabetes mellitus who were hospitalized in 13-3A-level general hospitals in Shandong Province from September 2018 to December 2021. According to the type of basal insulin used, the patients were divided into insulin degludec group and insulin glargine U100 group. The basic information and laboratory test results in patients in the 2 groups were collected, the differences of fasting blood glucose level and incidence of hypoglycemia between the 2 groups were compared. The patients with complete blood glucose monitoring data in the 2 groups were selected and their blood glucose fluctuations were compared. Results A total of 1-152 patients were entered in the study, including 552 patients in the insulin degludec group and 600 patients in the insulin glargine U100 group. The difference in the basic conditions in patients in the 2 groups was not statistically significant (all P>0.05). After treatment, the fasting blood glucose levels in patients in the 2 groups were lower than those before treatment, with statistically significant differences ［10.2 (8.8, 12.5) mmol/L vs. 7.5 (6.6, 8.7) mmol/L, Z=-19.443, P<0.001; 10.0 (8.6, 11.7) mmol/L vs. 7.8 (6.6, 9.0) mmol/L, Z=-15.449, P<0.001］, but the difference in fasting blood glucose levels between the 2 groups after treatment was not statistically significant (Z=-1.427, P>0.05). The incidence of hypoglycemia in the insulin degludec group was lower than that in the insulin glargine U100 group ［1.09% (6/552) vs. 2.83% (17/600), Z=4.481, P=0.032］. The intraday blood glucose standard deviation, maximum blood glucose fluctuation range, postprandial blood glucose fluctuation range, and average blood glucose fluctuation range in patients with complete blood glucose monitoring data in the insulin degludec group were significantly lower than those in the insulin glargine U100 group ［(1.7±0.6) mmol/L vs. (2.4±1.0) mmol/L, (4.5±1.6) mmol/L vs. (6.7±2.9) mmol/L, (1.8±1.0) mmol/L vs. (3.3±1.2) mmol/L, (2.9±1.3) mmol/L vs. (4.6±2.1) mmol/L; all P<0.001］. Conclusion The efficacy of insulin degludec in the treatment of type 2 diabetes mellitus is equivalent to that of insulin glargine U100, but the risk of hypoglycemia and blood glucose fluctuation is lower.
