LAUSR

INTRODUCTION Benefits of once-daily insulin degludec/aspart (IDegAsp) compared to basal insulin in type 2 diabetes has not been established. MATERIALS AND METHODS This is a retrospective observational study. From a basal insulin cohort from 3 referral hospitals, patients were enrolled who initiated once-daily IDegAsp. A control group maintaining basal insulin was selected by Propensity-score matching. HbA1c changes over 6 months and associated clinical factors were evaluated. RESULTS IDegAsp group and the control were comprised of 87 patients, respectively. Baseline HbA1c was comparable between the two groups (8.7±0.9 vs. 8.6±0.9%, mean and Standard deviation). After 6 months with matched insulin doses, HbA1c in the IDegAsp group was lower than that in the control (8.1±1.0 vs 8.4±1.1%, P=0.029). Among baseline variables, FPG and fasting C-peptide in the IDegAsp were lower than that in the control (FPG, 124.2±38.4 vs 148.0±50.6 mg/dL, P<0.001). Considering that the lower FPG despite the comparable HbA1c could be related with the efficacy of IDegAsp, subgroup analysis was done according to a ratio of FPG to estimated average glucose (eAG) which is calculated from HbA1c. When compared to each control group, the superiority of IDegAsp in the reduction of HbA1c was significant only in the patients with lower FPG/eAG ratio (0.49±0.09), but not in those with higher FPG/eAG ratio (0.79 ± 0.20). CONCLUSION We observed that IDegAsp was more effective than basal insulin in patients with an FPG lower than predicted by HbA1c, which might be related with insulin deficiency and postprandial hyperglycemia in patients on basal insulin therapy.