Effects of Ultra-Long-Acting Insulin Compared to Long-Acting Insulin on Diabetic Ketoacidosis Incidence in Type 1 Diabetes Mellitus Patients

Figures & data

Table 1 Sociodemographic and Clinical Characteristics of the Study Participants

Baseline Characteristics of the Patients	Values
Age (years), mean [SD]	23.3 [6.8]
Sex, N (%)
Male	90 (40.7)
Female	131 (59.3)
Comorbid conditions, N (%)*
Hypertension	8 (3.6)
Dyslipidemia	45 (20.6)
Hypothyroidism	52 (23.5)
Diabetic nephropathy	46 (20.8)
Diabetic retinopathy	9 (4.1)
Celiac disease	14 (6.3)
Other used medications, N (%)
Sodium-glucose co-transporter-2	3 (1.4)
Levo-thyroxine	51 (23.1)
Angiotensin-converting enzyme inhibitors	53 (24.0)
Statin	43 (19.5)
Age at diagnosis (years), mean [SD]	11 [6.3]
Type 1 diabetes mellitus duration (years), mean [SD]	12.4 [6.6]
Body mass index (kg/m^2), mean [SD]	24.1 [5.1]
Creatinine clearance (mL/min), mean [SD]	1.7 [0.51]

Note: *May not add up to 100% due to rounding.

Table 2 Measures of Diabetes Clinical Outcomes

Insulin Outcomes	Long-Acting Insulin Therapy		Ultra-long-Acting Insulin Therapy		Difference
	Mean (SD)	Range	Mean (SD)	Range	Change Score	P value
Hemoglobin A1c (%)	9.9 (2.3)	5.3–17.6	9.8 (2.1)	6.2–17.7	0.07	0.4508
Total daily insulin dose (units)*	76.6 (27.3)	16–169	79.3 (27.1)	22–202	−2.67	0.0265
Total daily Basal insulin dose (units)	30.6 (12.1)	6–84	30.3 (11.1)	8–68	0.3	0.5373

Note: *Significant at P <0.05.

Table 3 Total Daily Dose Variation (Sub-Analysis for Both Basal Insulin Types: Glargine U300 and Degludec U100)

	N	Long-Acting Insulin	Ultra-Long-Acting Insulin	P value
		Mean Total Daily Dose (SD)	Mean Total Daily Dose (SD)
Insulin Degludec U100	115	79.5 (26.7)	80.5 (27.9)	0.5971
Insulin Glargine U300	106	73.5 (27.7)	78.1 (26.3)	0.0021*

Note: *Significant at P <0.05.

Table 4 The Marginal Response of Diabetic Ketoacidosis (DKA)

Long-Acting Insulin	Frequency	Percent
DKA occurred	11	4.9
DKA did not occur	210	95.1
Ultra-long-acting insulin
DKA occurred	12	5.4
DKA did not occur	209	94.6

Table 5 Frequency of Diabetic Ketoacidosis (DKA) Before and After Using Insulin Degludec U100 or Glargine U300; Sub-Analysis

	Long-Acting Insulin		Degludec Regimen		P value
	Frequency	Percent	Frequency	Percent
DKA occurred	8	6.9	6	5.2	0.5637
DKA did not occur	107	93.1	109	94.8
Frequency of DKA before and after insulin using glargine U300; sub-analysis
	Long-acting Insulin		Glargine U300 regimen		P value
	Frequency	Percent	Frequency	Percent
DKA occurred	3	2.8	6	5.7	0.2568
DKA did not occur	103	97.2	100	94.3