J Endocrinol Metab

Journal of Endocrinology and Metabolism, ISSN 1923-2861 print, 1923-287X online, Open Access

Article copyright, the authors; Journal compilation copyright, J Endocrinol Metab and Elmer Press Inc

Journal website http://www.jofem.org

Short Communication

Volume 3, Number 6, December 2013, pages 138-146

Comparison of Glycemic Variability by Using Insulin Glargine and Insulin Degludec in Japanese Patients With Type 1 Diabetes, Monitored by Continuous Glucose Monitoring: A Preliminary Report

Figure 2. Changes of the 24 h glucose variation in four patients with type 1 diabetes, by switching from insulin glargine to insulin degludec, monitored by continuous glucose monitoring. Patients 1 - 4 correspond with Patient 1 - 4 in Table 1 and Table 2. The 24 h glucose variation in the upper row and the lower row indicate the 24 h glucose variation by using insulin glargine and insulin degludec, respectively. Blue small boxes and black arrows indicate adjustment for continuous glucose monitoring by self-measured blood glucose, and the development of hypoglycemia (< 70 mg/dL).

**Table 1.** Clinical, Biochemical and Immunological Characteristics of Patients
Patients	1	2	3	4
Age (years old)	30	48	55	68
Sex	Female	Male	Female	Female
Duration of disease (years)	11	12	3	33
Height (cm)	154.7	170.0	157.6	148.5
Weight (kg)	55.1	55.8	63.9	56.6
Body mass index (kg/m²)	23.0	19.3	25.7	25.7
HbA1c (%)	11.0	9.5	10.0	7.4
Serum C-peptide levels (ng/mL)	0.08	0.06	0.11	0.46
Urinary C-peptide levels (µg/day)	1.9	8.1	8.2	25.3
Anti-GAD antibodies (U/mL)	< 0.3	< 0.3	7,200	21.0
Anti-IA2 antibodies (U/mL)	< 0.4	< 0.4	5.1	< 0.4

Table 1. Clinical, Biochemical and Immunological Characteristics of Patients

Patients

Age (years old)

Sex

Female

Male

Female

Duration of disease (years)

Height (cm)

154.7

170.0

157.6

148.5

Weight (kg)

55.1

55.8

63.9

56.6

Body mass index (kg/m²)

23.0

19.3

25.7

HbA1c (%)

11.0

9.5

10.0

7.4

Serum C-peptide levels (ng/mL)

0.08

0.06

0.11

0.46

Urinary C-peptide levels (µg/day)

1.9

8.1

8.2

25.3

Anti-GAD antibodies (U/mL)

< 0.3

7,200

21.0

Anti-IA2 antibodies (U/mL)

< 0.4

5.1

< 0.4

**Table 2.** Changes of Bolus, Basal and Total Daily Insulin Dosage in Four Patients With Type 1 Diabetes, by Switching From Insulin Glargine to Insulin Degludec. Patients 1 - 4 Correspond With Patient 1 - 4 in Table 1 and Patient 1 - 4 in Figure 2.
Patients	Bolus insulin (units)	Basal insulin (units)	Total daily insulin (units)
During the insulin glargine treatment
1	8	6	4	18	36
2	24	10	14	18	66
3	9	8	8	30	55
4	6	4	6	9	25
During the insulin degludec treatment
1	8	6	4	18	36
2	18	10	14	16	58
3	7	6	6	29	48
4	6	4	6	9	25

Table 2. Changes of Bolus, Basal and Total Daily Insulin Dosage in Four Patients With Type 1 Diabetes, by Switching From Insulin Glargine to Insulin Degludec. Patients 1 - 4 Correspond With Patient 1 - 4 in Table 1 and Patient 1 - 4 in Figure 2.

Patients

Bolus insulin (units)

Basal insulin (units)

Total daily insulin (units)

before breakfast

before lunch

before dinner

at bedtime

During the insulin glargine treatment

During the insulin degludec treatment

**Table 3.** Changes in Parameters in Glycemic Variability by Switching From Insulin Glargine to Insulin Degludec, Monitored by Continuous Glucose Monitoring
	Insulin glargine	Insulin degludec	P value*
Data present as median ± quartile deviation. *Statistical analyzed were done by the Mann-Whitney U test.
24 h mean glucose levels (mg/dL)	193.5 ± 57.0	119.6 ± 28.7	0.057
24 h area under the glucose curve (× 10⁴ mg/dL•min)	27.9 ± 6.21	17.2 ± 4.09	0.057
SD of 24 h glucose levels	50.8 ± 16.3	28.8 ± 14.7	0.083
M-value	156.8 ± 135.7	10.6 ± 7.0	0.021
Mean amplitude of glycemic excursions	92.4 ± 36.1	56.1 ± 33.5	0.309
Time in hyperglycemia (> 180 mg/dL) (min)	567.5 ± 486.3	32.5 ± 268.0	0.083
Time in hypoglycemia (< 70 mg/dL) (min)	0	0 ± 42.5	0.317

Table 3. Changes in Parameters in Glycemic Variability by Switching From Insulin Glargine to Insulin Degludec, Monitored by Continuous Glucose Monitoring

Insulin glargine

Insulin degludec

P value*

Data present as median ± quartile deviation. *Statistical analyzed were done by the Mann-Whitney U test.

24 h mean glucose levels (mg/dL)

193.5 ± 57.0

119.6 ± 28.7

0.057

24 h area under the glucose curve (× 10⁴ mg/dL•min)

27.9 ± 6.21

17.2 ± 4.09

0.057

SD of 24 h glucose levels

50.8 ± 16.3

28.8 ± 14.7

0.083

M-value

156.8 ± 135.7

10.6 ± 7.0

0.021

Mean amplitude of glycemic excursions

92.4 ± 36.1

56.1 ± 33.5

0.309

Time in hyperglycemia (> 180 mg/dL) (min)

567.5 ± 486.3

32.5 ± 268.0

0.083

Time in hypoglycemia (< 70 mg/dL) (min)

0 ± 42.5

0.317