Scholarlink

Background <p>The optimal approach for transitioning hospitalized patients with type 2 diabetes (T2DM) from continuous subcutaneous insulin infusion (CSII) to second-generation basal insulin analogues remains unclear. This exploratory study aimed to: (1) evaluate whether a smooth transition from CSII to each second‑generation basal insulin analogue (insulin degludec [IDeg] or insulin glargine U300 [IGlar U300]) could be achieved; (2) compare post‑transition glycemic outcomes between IDeg and IGlar U300; and (3) identify patient characteristics associated with transition outcomes.</p> Methods <p>This single-center retrospective analysis included 135 hospitalized adults with T2DM who received CSII therapy upon admission and were transitioned to basal insulin analogues before discharge (IDeg, <i>n</i> = 77; IGlar U300, <i>n</i> = 58). Among these, 90 patients (IDeg: 50; IGlar U300: 40) were insulin-naive at admission. Glycemic outcomes were assessed using continuous glucose monitoring metrics.</p> Results <p>Within‑group comparisons showed significant improvements from CSII to post‑transition in both groups: time in range increased from 56.4% to 73.0% in the IDeg group (<i>P</i> &lt; 0.001) and from 58.3% to 73.6% in the IGlar U300 group (<i>P</i> &lt; 0.001). Between‑group comparisons after transition revealed comparable profiles between IDeg and IGlar U300 across key metrics: overall control (time in range: 73.0% vs. 73.6%, <i>P</i> = 0.912), glycemic variability (coefficient of variation: 29.8% vs. 29.2%, <i>P</i> = 0.629), and hypoglycemia risk (time below range: 0.8% vs. 0.5%, <i>P</i> = 0.915). IDeg demonstrated lower fasting glucose variability (coefficient of variation of fasting glucose: 23.8% vs. 28.3%, <i>P</i> = 0.024) and a later nocturnal glucose nadir. Lower body mass index correlated strongly with poorer post-transition outcomes, coinciding with more frequent use of multiple daily injection regimens in these patients (36.1% vs. 6.3%, <i>P</i> &lt; 0.001). Lower serum albumin consistently associated with greater glycemic variability.</p> Conclusions <p>Transition from CSII to either IDeg or IGlar U300 is effective and safe. IDeg may provide greater fasting glucose stability. Transition success requires personalized discharge planning based on BMI and albumin levels.</p> Clinical trial number <p>Not applicable.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Transition from CSII to second-generation basal insulin analogues in hospitalized T2DM patients: a CGM-based study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年5月9日

查看全文
  • Ruiqing Dong,
  • Hui Liu,
  • Lifan Gu,
  • Qiange Zhao,
  • Chenwen Luo,
  • Ting Zhang,
  • Xuna Kou,
  • Yuanna Hu,
  • Bingyin Shi,
  • Hui Guo,
  • Wei Qiang

摘要

Background

The optimal approach for transitioning hospitalized patients with type 2 diabetes (T2DM) from continuous subcutaneous insulin infusion (CSII) to second-generation basal insulin analogues remains unclear. This exploratory study aimed to: (1) evaluate whether a smooth transition from CSII to each second‑generation basal insulin analogue (insulin degludec [IDeg] or insulin glargine U300 [IGlar U300]) could be achieved; (2) compare post‑transition glycemic outcomes between IDeg and IGlar U300; and (3) identify patient characteristics associated with transition outcomes.

Methods

This single-center retrospective analysis included 135 hospitalized adults with T2DM who received CSII therapy upon admission and were transitioned to basal insulin analogues before discharge (IDeg, n = 77; IGlar U300, n = 58). Among these, 90 patients (IDeg: 50; IGlar U300: 40) were insulin-naive at admission. Glycemic outcomes were assessed using continuous glucose monitoring metrics.

Results

Within‑group comparisons showed significant improvements from CSII to post‑transition in both groups: time in range increased from 56.4% to 73.0% in the IDeg group (P < 0.001) and from 58.3% to 73.6% in the IGlar U300 group (P < 0.001). Between‑group comparisons after transition revealed comparable profiles between IDeg and IGlar U300 across key metrics: overall control (time in range: 73.0% vs. 73.6%, P = 0.912), glycemic variability (coefficient of variation: 29.8% vs. 29.2%, P = 0.629), and hypoglycemia risk (time below range: 0.8% vs. 0.5%, P = 0.915). IDeg demonstrated lower fasting glucose variability (coefficient of variation of fasting glucose: 23.8% vs. 28.3%, P = 0.024) and a later nocturnal glucose nadir. Lower body mass index correlated strongly with poorer post-transition outcomes, coinciding with more frequent use of multiple daily injection regimens in these patients (36.1% vs. 6.3%, P < 0.001). Lower serum albumin consistently associated with greater glycemic variability.

Conclusions

Transition from CSII to either IDeg or IGlar U300 is effective and safe. IDeg may provide greater fasting glucose stability. Transition success requires personalized discharge planning based on BMI and albumin levels.

Clinical trial number

Not applicable.