Skip to main content
Top
Published in: Diabetes Therapy 4/2019

Open Access 01-08-2019 | Insulin Glargine | Brief Report

Differential Effect of Hypoalbuminemia on Hypoglycemia on Type 2 Diabetes Patients Treated with Insulin Glargine 300 U/ml and Insulin Degludec

Authors: Yuji Kawaguchi, Jun Sawa, Chie Hamai, Yasuro Kumeda

Published in: Diabetes Therapy | Issue 4/2019

Login to get access

Abstract

Introduction

Hypoglycemia resulting from insulin therapy for treatment of diabetes increases the risk of adverse cardiovascular events. Determining biomarkers that provide accurate estimation of hypoglycemia risk may allow for more accurate patient management and care. The purpose of this study was to determine the cutoff value of serum albumin (s-alb) that increases the risk of hypoglycemia in patients treated with insulin degludec.

Methods

This study used a crossover design and randomized 30 patients admitted for glycemic control to compare differences between insulin glargine 300 U/ml (Gla300) and degludec treatments.

Results

The cutoff value of s-alb associated with 24-h hypoglycemia and nocturnal hypoglycemia in patients treated with degludec was 3.8 g/dl. In patients with s-alb levels < 3.8 g/dl, mean percentages of time with hypoglycemia, clinically important hypoglycemia, and nocturnal hypoglycemia were significantly lower in those treated with Gla300 compared with patients treated with degludec.

Conclusion

This study identified a cutoff value for s-alb levels that indicates risk of hypoglycemia in patients treated with degludec. Monitoring s-alb levels in patients treated with degludec will help to mitigate the risk of hypoglycemia.

Trial Registration

University Hospital Medical Information Network (UMIN 000031044).
Appendix
Available only for authorised users
Literature
1.
go back to reference Frier BM, Schernthaner G, Heller SR. Hypoglycemia and cardiovascular risks. Diabetes Care. 2011;34(Supplement 2):S132–7.CrossRef Frier BM, Schernthaner G, Heller SR. Hypoglycemia and cardiovascular risks. Diabetes Care. 2011;34(Supplement 2):S132–7.CrossRef
2.
go back to reference Yki-Jarvinen H, Bergenstal R, Ziemen M, Muehlen-Bartmer I, Boelle E, Riddle MC. New insulin glargine 300 units/ml versus glargine 100 units/ml in people with type 2 diabetes using oral agents and basal insulin: glucose control and hypoglycemia in a 6-month randomized controlled trial (EDITION 2). Diab Care. 2014;37:3235–43.CrossRef Yki-Jarvinen H, Bergenstal R, Ziemen M, Muehlen-Bartmer I, Boelle E, Riddle MC. New insulin glargine 300 units/ml versus glargine 100 units/ml in people with type 2 diabetes using oral agents and basal insulin: glucose control and hypoglycemia in a 6-month randomized controlled trial (EDITION 2). Diab Care. 2014;37:3235–43.CrossRef
3.
go back to reference Wysham C, Bhargava A, Chaykin L, et al. Effect of insulin degludec vs insulin glargine U100 on hypoglycemia in patients with type 2 diabetes: the SWITCH 2 randomized clinical trial. JAMA. 2017;318:45–56.CrossRef Wysham C, Bhargava A, Chaykin L, et al. Effect of insulin degludec vs insulin glargine U100 on hypoglycemia in patients with type 2 diabetes: the SWITCH 2 randomized clinical trial. JAMA. 2017;318:45–56.CrossRef
4.
go back to reference Rosenstock J, Cheng A, Ritzel R, et al. More similarities than differences testing Insulin glargine 300 units/ml versus insulin degludec 100 units/ml in insulin-naive type 2 diabetes: the randomized head-to-head BRIGHT Trial. Diab Care. 2018;41:2147–54.CrossRef Rosenstock J, Cheng A, Ritzel R, et al. More similarities than differences testing Insulin glargine 300 units/ml versus insulin degludec 100 units/ml in insulin-naive type 2 diabetes: the randomized head-to-head BRIGHT Trial. Diab Care. 2018;41:2147–54.CrossRef
5.
go back to reference Kawaguchi Y, Sawa J, Sakuma N, Kumeda Y. Efficacy and safety of insulin glargine 300 U/ml vs insulin degludec in patients with type 2 diabetes: a randomized, open-label, cross-over study using continuous glucose monitoring profiles. J Diabetes Investig. 2019;10:343–51.CrossRef Kawaguchi Y, Sawa J, Sakuma N, Kumeda Y. Efficacy and safety of insulin glargine 300 U/ml vs insulin degludec in patients with type 2 diabetes: a randomized, open-label, cross-over study using continuous glucose monitoring profiles. J Diabetes Investig. 2019;10:343–51.CrossRef
6.
go back to reference Vora J, Cariou B, Evans M, et al. Clinical use of insulin degludec. Diabetes Res Clin Pract. 2015;109:19–31.CrossRef Vora J, Cariou B, Evans M, et al. Clinical use of insulin degludec. Diabetes Res Clin Pract. 2015;109:19–31.CrossRef
7.
go back to reference Kalra S, Unnikrishnan AG, Baruah M, Kalra B. Degludec insulin: a novel basal insulin. Indian J Endocrinol Metab. 2011;15(Suppl 1):S12–6.CrossRef Kalra S, Unnikrishnan AG, Baruah M, Kalra B. Degludec insulin: a novel basal insulin. Indian J Endocrinol Metab. 2011;15(Suppl 1):S12–6.CrossRef
8.
go back to reference Heise T, Mathieu C. Impact of the mode of protraction of basal insulin therapies on their pharmacokinetic and pharmacodynamic properties and resulting clinical outcomes. Diabetes Obes Metab. 2017;19:3–12.CrossRef Heise T, Mathieu C. Impact of the mode of protraction of basal insulin therapies on their pharmacokinetic and pharmacodynamic properties and resulting clinical outcomes. Diabetes Obes Metab. 2017;19:3–12.CrossRef
9.
go back to reference Mathieu C, Gillard P, Benhalima K. Insulin analogues in type 1 diabetes mellitus: getting better all the time. Nat Rev Endocrinol. 2017;13:385–99.CrossRef Mathieu C, Gillard P, Benhalima K. Insulin analogues in type 1 diabetes mellitus: getting better all the time. Nat Rev Endocrinol. 2017;13:385–99.CrossRef
10.
go back to reference Hochberg I. Insulin detemir use is associated with higher occurrence of hypoglycemia in hospitalized patients with hypoalbuminemia. Diabetes Care. 2018;41:e44–6.CrossRef Hochberg I. Insulin detemir use is associated with higher occurrence of hypoglycemia in hospitalized patients with hypoalbuminemia. Diabetes Care. 2018;41:e44–6.CrossRef
11.
go back to reference Goldman J, Lee WK. Insulin detemir—a new basal insulin analog. Ann Pharmacother. 2005;39:502–7.CrossRef Goldman J, Lee WK. Insulin detemir—a new basal insulin analog. Ann Pharmacother. 2005;39:502–7.CrossRef
12.
go back to reference Jonassen I, Havelund S, Hoeg-Jensen T, Steensgaard DB, Wahlund PO, Ribel U. Design of the novel protraction mechanism of insulin degludec, an ultra-long-acting basal insulin. Pharm Res. 2012;29:2104–14.CrossRef Jonassen I, Havelund S, Hoeg-Jensen T, Steensgaard DB, Wahlund PO, Ribel U. Design of the novel protraction mechanism of insulin degludec, an ultra-long-acting basal insulin. Pharm Res. 2012;29:2104–14.CrossRef
13.
go back to reference Kurtzhals P, Havelund S, Jonassen I, et al. Albumin binding of insulins acylated with fatty acids: characterization of the ligand-protein interaction and correlation between binding affinity and timing of the insulin effect in vivo. Biochem J. 1995;312:725–31.CrossRef Kurtzhals P, Havelund S, Jonassen I, et al. Albumin binding of insulins acylated with fatty acids: characterization of the ligand-protein interaction and correlation between binding affinity and timing of the insulin effect in vivo. Biochem J. 1995;312:725–31.CrossRef
14.
go back to reference Unnikrishnan AG, Bantwal G, Sahay RK. Translating structure to clinical properties of an ideal basal insulin. J Assoc Physicians India. 2014;62(1 Suppl):15–20.PubMed Unnikrishnan AG, Bantwal G, Sahay RK. Translating structure to clinical properties of an ideal basal insulin. J Assoc Physicians India. 2014;62(1 Suppl):15–20.PubMed
15.
go back to reference Bolli GB, Gottesman IS, Campbell PJ, Haymond MW, Cryer PE, Gerich JE. Glucose Counterregulation and waning of insulin in the Somogyi phenomenon (posthypoglycemic hyperglycemia). N Engl J Med. 1984;311(19):1214–9.CrossRef Bolli GB, Gottesman IS, Campbell PJ, Haymond MW, Cryer PE, Gerich JE. Glucose Counterregulation and waning of insulin in the Somogyi phenomenon (posthypoglycemic hyperglycemia). N Engl J Med. 1984;311(19):1214–9.CrossRef
Metadata
Title
Differential Effect of Hypoalbuminemia on Hypoglycemia on Type 2 Diabetes Patients Treated with Insulin Glargine 300 U/ml and Insulin Degludec
Authors
Yuji Kawaguchi
Jun Sawa
Chie Hamai
Yasuro Kumeda
Publication date
01-08-2019
Publisher
Springer Healthcare
Published in
Diabetes Therapy / Issue 4/2019
Print ISSN: 1869-6953
Electronic ISSN: 1869-6961
DOI
https://doi.org/10.1007/s13300-019-0654-y

Other articles of this Issue 4/2019

Diabetes Therapy 4/2019 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.