Aim: Insulin degludec and aspart (IDegAsp) is the first soluble insulin preparation to combine two different types of insulin analogs in one pen. However, there are few reports describing the long-term use of IDegAsp in clinical practice.
Method: 140 outpatients received IDegAsp during the period between Feb 2016 and Dec 2017 and were retrospectively analyzed for HbA1c, body weight, and units of insulin used (mean follow-up period, 8.2 months). Also, a questionnaire survey was conducted 3 months after the introduction of IDegAsp, to assess patient satisfaction (Q1, device usability; Q2, glycemic control; Q3, frequency of hypoglycemia; Q4, formulation not requiring suspension procedure). The subjects were 69 men and 71 women with a mean age of 64 years, HbA1c of 8.8 %, and body weight of 59.0 kg. Treatment before IDegAsp introduction included no previous insulin therapy (group A) in 46 patients, once daily injection of long-acting insulin in 28 patients, twice daily injection of premixed insulin in 20 patients, once daily injection of premixed insulin in 13 patients, and intensive insulin therapy in 33 patients.
Results: The changes in HbA1c after the introduction of IDegAsp in the subjects overall were 8.1% (1 month [M]), and 7.3% (6 M), showing significant improvement as compared with the values before introduction. The body weights were 57.5 kg (1 M), and 57.6 kg (6 M), showing no significant changes. The changes in HbA1c, according to prior treatment, were 10.3% (0 M), 8.7% (1 M), and 7.0% (6 M) in group A, with each value showing significant improvement as compared with the baseline. In the patient survey on the use of IDegAsp, the percentages of patients responding "very good" or "good" to Q1, Q2, Q3, and Q4 were 31%, 85%, 91%, and 43%, respectively.
Discussion: The introduction of IDegAsp consistently improved glucose metabolism. Also, the patient questionnaire showed mostly favorable results with use of IDegAsp. We plan to conduct a further study and report the results including a detailed assessment of each group.
M. Kusama: None.