Exp Clin Endocrinol Diabetes
DOI: 10.1055/s-0043-113453
Article
© Georg Thieme Verlag KG Stuttgart · New York

Switching from Premixed Insulin To Basal Insulin Analogue For Type 2 Diabetes and Role of Dipeptidyl Peptidase-4 Inhibitors

Fernando Gómez-Peralta1, Cristina Abreu1, Gustavo Mora-Navarro2, Pilar López-Morandeira3, Esteban Pérez-Gutierrez4, Blanca Cordero-García5, Miguel Brito-Sanfiel6
  • 1Unit of Endocrinology and Nutrition, Hospital General de Segovia, Miguel Servet, S/N, Segovia, Spain
  • 2Department of General Medicine, Centro de Salud Los Alpes, Calle Suecia, Madrid, Spain
  • 3Department of General Medicine, Centro de Salud Aquitania, Calle Aquitania, Madrid, Spain
  • 4Department of General Medicine, Centro de Salud María Jesús Hereza, Calle Jesús Miguel Haddad Blanco, Leganés, Spain
  • 5Department of General Medicine, Centro de Salud Santa María Benquerencia, Calle Río Alberche, S/N, 45007 Toledo, Spain
  • 6Unit of Endocrinology and Nutrition, Hospital Universitario Puerta de Hierro Majadahonda, Calle Manuel de Falla, Majadahonda, Spain
Further Information

Publication History

received 16 February 2017
revised 07 June 2017

accepted 12 June 2017

Publication Date:
13 July 2017 (eFirst)

Abstract

Introduction This study aimed to confirm the usefulness of basal insulin analogue plus oral antidiabetic drugs (OADs) for type 2 diabetes (T2D) patients inadequately controlled with premixed insulin with/without OADs and assess the role of dipeptidyl peptidase-4 (DPP-4) inhibitors within this regimen in clinical practice.

Methods Spanish retrospective observational study that included 186 T2D patients with glycosylated hemoglobin (HbA1c) >7% (53 mmol/mol) despite premixed insulin with/without OADs who had been switched to basal insulin analogue plus OADs. Study data describing the situation before the treatment switch and 6 months later was retrospectively retrieved from patients’ medical charts.

Results Switching to a basal insulin plus OADs decreased HbA1c (−1.0%, p<0.001), fasting (−38.1 mg/dl, p<0.001) and postprandial glycemia (−36.1 mg/dl, p<0.001), with reduced body weight (−1.1 kg, p<0.001) and hypoglycemic episodes (−17.5%, p<0.001). 68 (36.6%) patients received a basal insulin plus DPP-4 inhibitor±metformin and 74 (39.8%) plus metformin only. The DPP-4 inhibitor±metformin group showed a greater HbA1c reduction than the metformin group (1.3±1.4% vs. 0.9±1.0%, p=0.022), with no significant differences between groups in hypoglycemic episodes.

Conclusions Basal insulin analogue plus OADs may be a useful treatment for type 2 diabetes patients inadequately controlled with premixed insulin. Administering DPP-4 inhibitors within this regimen may contribute to improve patients’ glycemia, with a favorable weight-change profile and without increasing hypoglycemia risk.