Insulin degludec improves long‐term glycaemic control similarly to insulin glargine but with fewer hypoglycaemic episodes in patients with advanced type 2 diabetes on basal‐bolus insulin therapy

The aim of the present study was to compare the long-term safety and efficacy of insulin degludecwith those of insulin glarginein patients with advanced type 2 diabetes (T2D) over 78 weeks (the 52-week main trial and a 26-week extension). Patients were randomized to once-daily insulin degludecor insulin glargine, with mealtime insulin aspart ± metformin ±  pioglitazone, and titrated to pre-breakfast plasma glucose values of 3.9–4.9 mmol/l (70–88 mg/dl). After 78 weeks, the overall rate of hypoglycaemia was 24% lower (p = 0.011) and the rate of nocturnalhypoglycaemia was 31% lower (p = 0.016) with insulin degludecin the extension trial set, while both groups of patients achieved similar glycaemic control. Rates of adverse events and total insulindoses were similar for both groups in the safety analysis set. During 18 months of treatment, insulin degludec + mealtime insulin aspart ± oral antidiabetic drugs in patients with T2D improves glycaemic control similarly, but confers lower risks of overall and nocturnalhypoglycaemia than with insulin glarginetreatment.