Experience of the use of insulin degludec in the treatment of patients with type 1 diabetes mellitus (according to the data of the Moscow segment of the Federal Diabetes Register)

Background. The basis of modern therapy for type 1 diabetes mellitus (DM1) is the replenishment of the basal and prandial insulin secretion. Introduction into clinical practice of new drugs with a profile of action similar to the physiological insulin action is an extremely important task. The beginning of the use of basal, non-peak long-acting insulin analogs in clinical practice opened the way to ensure adequate glycemic control at night with minimal risk of hypoglycemic states. A new drug of this class, insulin degludec, has demonstrated new possibilities for effectively controlling the glycated hemoglobin (HbA1c) level, reducing glycemic variability and ensuring a low risk of general, nocturnal and severe hypoglycemia compared to other basal insulins. Objective. Evaluation of the glycemic control parameters in patients with type 1 diabetes mellitus receiving insulin degludec. Methods. On the basis of the Moscow segment of the Federal Diabetes register, a sample of patients with type 1 diabetes receiving therapy with insulin deludec since 2016 (n=178) was formed. A statistical analysis of the patient data was conducted: age and sex, the average HbA1c level, the average dose of basal and prandial insulin before insulin degludec administration, and the dynamics of these indicators for 3 years was analyzed. Results. A statistically significant decrease in HbA1с level by 0.6% (from 8.2 to 7.6%) in the period from 2015 to 2016 inclusive (the period of transferring patients to the therapy with insulin degludec) and stable retention of HbA1c at a level of 7.4 % in the next 2 years was revealed. A statistically significant decrease in the average total dose of insulin by 0.04 U/kg (from 0.88 to 0.84 U/kg) due to a decrease in the dose of basal insulin by 0.03 U/kg was observed (p<0.05). At the same time, there was a non-significant tendency to a decrease in the dose of prandial insulin. Conclusion. The transfer of DM1 patients to insulin degludec leads to a statistically significant decrease in HbA1c level. The achieved reduction in HbA1c level persists for at least 2 years. The transfer of DM1 patients to insulin degludec is accompanied by a statistically significant reduction in the dose of basal insulin, while there is no statistically significant change in the dose of prandial insulin.

type 1 diabetes mellitus, insulin therapy, glycated hemoglobin, registry, insulin degludec