In whom and why a dual-analog insulin aspart + degludec is worth to be used? Review article
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Abstract
Recent years have brought significant paradigm changes in the treatment of type 2 diabetes. After the announcement of the results of the first and subsequent studies on the cardiovascular safety of antidiabetic drugs, non-insulin drugs came to the forefront, with sodium-glucose cotransporter type 2 inhibitors and glucagon-like peptide-1 receptor agonists occupying a special place (the latter are recommended as the first injectable therapy in type 2 diabetes). This resulted in a slight decrease in the number of patients treated with insulin. Nevertheless, it should be remembered that in the population of people with type 2 diabetes, many patients will sooner or later need to implement insulin therapy. It is usually initiated with a single injection of basal insulin, which in our circumstances is usually NPH insulin. The lack of effectiveness of this therapy requires further intensification of treatment by adding further injections of mealtime insulin. One of available options is to use a combination of the fast-acting analog insulin aspart (IAsp) and the ultra-long-acting analog insulin degludec (IDeg) in one pen, each maintaining its own pharmacokinetic profile. The advantage of this option is fewer injections with comparable or better glycemic control compared to other treatment regimens, and the additional benefit for the patient is the reduction of hypoglycaemia, especially nocturnal. This treatment allows further intensification of therapy by adding a second injection of IDegAsp, or subsequent injections of mealtime insulin. IDegAsp insulin can also be used to initiate insulin therapy in conditions of severe hyperglycaemia, to replace therapy with premixed human or analog insulins with one or two injections of IDegAsp insulin, and even this does not exhaust the full spectrum of its possible applications. In summary, IDegAsp insulin is a valuable and safe supplement to insulin therapy in patients with type 2 and type 1 diabetes.
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References
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