735-P: Effects of Insulin Degludec in Patients with Diabetes Using Continuous Glucose Monitoring: A Scoping Review

Background: The ultra-long-acting insulin degludec (Deg) was reported to have more stable glucose lowering effect with lower risk of hypoglycemia. This review aimed to summarize data on efficacy and safety of Deg in patients with T1DM or T2DM using continuous glucose monitoring (CGM). Methods: A systematic literature search of studies on Deg in PubMed, EMBASE and Web of Science was performed for articles published before January 2021. Studies reporting data on the efficacy and safety of Deg in patients with diabetes using CGM were included. Results: Thirteen studies with CGM data in 262 patients with T1DM or T2DM were included. The studies were conducted in Japan (11 studies) and Italy (2 studies). Eleven studies focused on patients with T1D (n=208) and two studies on T2D (n=54). The studies compared Deg with insulin glargine 100U/mL (n=130), insulin glargine 300U/mL (n=100), or insulin detemir (n=32). Regarding the study design, six studies were cross-over and seven studies were switching from other basal insulin to Deg. The sample sizes ranged from 7 to 46. The duration of Deg treatment varied between 3 days to 24 weeks. Three studies reported significant improvement of within-day or between-day glycemic variability by Deg, while the other ten studies revealed no difference in glycemic variability. The glucose lowering effect of Deg was comparable to other basal insulin in eleven studies, while two studies found that Deg could further improve glycemic control. Total daily insulin dose reduced in seven studies switching to Deg, while the insulin dose remained unchanged in six studies. In two studies, Deg reduced hypoglycemia when compared with glargine 100U/mL or detemir, which was not observed in other eight studies. However, three studies showed higher percentage time of hypoglycemia with Deg than glargine 300U/mL. Conclusion: Deg leads to similarly effective, stable and safe glycemic control with comparable insulin dose requirement to other basal insulin on the current evidence. Disclosure C. Wang: None. W. Xu: None. X. Yang: None. J. Yan: None. D. Yang: None. B. Yao: None. J. Weng: None. Funding Johnson & Johnson Medical Devices Companies; Novo Nordisk (to J.W.)