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Probably Better, Definitely more expensive

Results / Limitations

Results

Results

Are we using the right Insulin?

Outcome

2012, Diabetes Care

"In this 1-year, parallel-group, randomized,open-label, treat-to-target trial, adults with type 2 diabetes with A1C of 7-10% taking OADs were randomized 3:1 to receive once daily degludec or glargine, both with metformin."

Comparator

Other Basal Insulins

Intervention

49 y/o male with pmhx significant for uncontrolled diabetes, now with a trending HBa1c, being considered for Insulin therapy.

Is Insulin Degludec better than Insulin Glargine or other Long Acting Insulins with regard to HBa1c reduction and side effect profile?

Mean terminal half-lives are 25.4 and 12.5 h for IDeg and IGlar

Patient

47 M with poorly controlled DM2, HTN, HL here for f/u DM. DM- A1c 9.4-8.7-7.7-9.3 -->12 Today. His preprandially morning Fingersticks are typically in the 140s. Has not had any symptoms of hypoglycemia. Lowest fingerstick was 120. He states that he is compliant with his medications. Over the past year he has endorsed a weight loss of ~ 20lbs, intentionally. Despite his trending HBa1c, he states that he has been doing better with his portion control. Approached again and pt still does not want insulin. Does construction for work which is very physically taxing, but due to the cold is unable to exercise regularly. Follows yearly with an ophthalmologist, last visit was in April 2016, next is in April 2017. He now follows with a podiatrist.

Renew Januvia 100 mg tablet

Renew glyBURIDE 5 mg-metformin 500 mg tablet

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