Degludec hospital trial: A randomized controlled trial comparing insulin degludec U100 and glargine U100 for the inpatient management of patients with type 2 diabetes
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Aims: Limited data exist about the use of insulin degludec in the hospital. This multicentre, non‐inferiority, open‐label, prospective randomized trial compared the safety and efficacy of insulin degludec‐U100 and glargine‐U100 for the management of hospitalized patients with type 2 diabetes. Methods: In total, 180 general medical and surgical patients with an admission blood glucose (BG) between 7.8 and 22.2 mmol/L, treated with oral agents or insulin before hospitalization were randomly allocated (1:1) to a basal‐bolus regimen using degludec (n = 92) or glargine (n = 88), as basal and aspart before meals. Insulin dose was adjusted daily to a target BG between 3.9 and 10.0 mmol/L. The primary endpoint was the difference in mean hospital daily BG between groups. Results: Overall, the randomization BG was 12.2 ± 2.9 mmol/L and glycated haemoglobin 84 mmol/mol (9.8% ± 2.0%). There were no differences in mean daily BG (10.0 ± 2.1 vs. 10.0 ± 2.5 mmol/L, p = .9), proportion of BG in target range (54·5% ± 29% vs. 55·3% ± 28%, p = .85), basal insulin (29.6 ± 13 vs. 30.4 ± 18 units/day, p = .85), length of stay [median (IQR): 6.7 (4.7‐10.5) vs. 7.5 (4.7‐11.6) days, p = .61], hospital complications (23% vs. 23%, p = .95) between treatment groups. There were no differences in the proportion of patients with BG <3.9 mmol/L (17% vs. 19%, p = .75) or <3.0 mmol/L (3.7% vs. 1.3%, p = .62) between degludec and glargine. Conclusion: Hospital treatment with degludec‐U100 or glargine‐U100 is equally safe and effective for the management of hyperglycaemia in general medical and surgical patients with type 2 diabetes.
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Data on the use of concentrated insulins such as glargine U-300, degludec U-200, and U-500 regular insulin in the inpatient and perioperative settings are limited and have shown variable results.
“Data on the use of concentrated insulins such as glargine U-300, degludec U-200, and U-500 regular insulin in the inpatient and perioperative settings are limited and have shown variable results (78-81).”
From 16. Diabetes Care in the Hospital: Standards of Care in Diabetes—2026 (2026) · cites this paper as [78]
The Discussion (page not available) reports an inpatient trial of glargine U-300 and describes earlier hospital studies of degludec as small and preliminary. But this paper's trial compares degludec U-100 with glargine U-100; our copy does not address inpatient or perioperative results for degludec U-200 or U-500 regular insulin, or establish variable results across the listed concentrated insulins. (LLM, conf=0.84)
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Self-citation
- Authors
- Galindo, R. J., Pasquel, F. J., Vellanki, P., Alicic, R., Lam, D. W., Fayfman, M., Migdal, A. L., Davis, G. M., Cardona, S., Urrutia, M. A., Perez‐Guzman, C., Zamudio‐Coronado, K. W., Peng, L., Tuttle, K. R., & Umpierrez, G. E.
- Affiliations
- Emory University (US)
- University of Washington (US)
- Icahn School of Medicine at Mount Sinai (US)
- Division of Endocrinology, Department of Medicine Emory University School of Medicine Atlanta Georgia USA
- ORCID
- Venue
- Diabetes, Obesity and Metabolism
- Publisher
- Wiley
- Published
- 2021-09-24
- Volume
- 24
- Issue
- 1
- Pages
- 42-49
- ISSN
- 1462-8902 (ISSN-L)
- 1463-1326
- PMC
- PMC8665002
- OpenAlex
- W3197692266
- Cited by
- 26
- References
- 30
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 6 · 2023: 4 · 2022: 6 · 2021: 1
- FWCI
- 3.17
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Diabetes Obesity and Metabolism (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (2uc4dk101108-02, UL1TR002378)
- National Institute of General Medical Sciences (K23GM128221)
- National Institute of Diabetes and Digestive and Kidney Diseases (U2CDK114886, UC4-DK-101108, K23DK113241, K23DK122199, UM1DK100846, U54DK083912, K23DK123384, U24DK114886, P30DK111024)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- insulin degludec, glargine, type 2 diabetes, hospitalized patients, multiple daily insulin injections, basal insulin, glycemic control, hypoglycemia, length of hospital stay, non-inferiority, insulin analogues, HbA1c, in-hospital complications, insulin dose adjustment
- MeSH terms
- Insulin Glargine, Blood Glucose, Diabetes Mellitus, Type 2, Glycated Hemoglobin, Hospitals, Humans, Hypoglycemic Agents, Inpatients, Prospective Studies, Insulin, Long-Acting
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