Efficacy and Safety of Short Term Usage of Insulin CoFormulation (IDegAsp) in Treatment Naive Type 2 Diabetes Mellitus Patients, Presenting with Severe Hyperglycemia and/ or Osmotic Symptoms-A Real World Observational Study

Background: Clinicians adapted early insulinisation as one of the strategies in patients with marked hyperglycemia and/or osmotic symptoms. Recently two Indian studies used basal insulin as the initial choice in such patients. Indians having a carbohydrate predominant diet have higher contribution of post prandial plasma glucose (PPPG) even in higher tertiles of glycosylated hemoglobin (HbA1c). Newer co-formulation insulin degludec/insulin as part (IDegAsp) in which the individual properties of basal and prandial insulins are preserved presents an opportunity to correct both fasting and post-prandial glucose with an advantage of single prick and simple regime. Aim: Retrospective data of early insulinisation with co-formulation insulin was looked at for evaluating the efficacy and safety of this insulin. Methods: Retrospective data of the treatment naïve recently diagnosed type 2 diabetes patients who were initiated on co-formulation insulin therapy along with metformin at the first visit were reviewed from the medical records of outpatients department (OPD) of diabetes and endocrinology of a tertiary care hospital at Kolkata. Total 41 subjects fulfilled the eligibility criteria for analysis. These subjects had a minimum follow-up of 12 weeks in the OPD setting. Results: Significant improvement in FPG, PPPG and HbA1cwas observed over the 12 week study period with 85.4% of the patients receiving once daily IDegASp. No significant changes in weight were noted. Only two patients reported symptomatic hypoglycemia and none were found to experience documented, severe or nocturnal hypoglycaemia during the entire study period. Conclusion: Administration of insulin IDegAsp once or twice daily is an effective and safe option for insulin naive Indian patients, presenting with severe hyperglycemia and/or osmotic symptoms.