Efficacy and safety of degludec U100 versus glargine U300 for the early postoperative management of patients with type 2 diabetes mellitus undergoing coronary artery bypass graft surgery: A non-inferiority randomized trial

Diabet Med. 2023 Jan;40(1):e15002. doi: 10.1111/dme.15002. Epub 2022 Nov 16.

Abstract

Aims: To compare the efficacy and safety of degludec U100 versus glargine U300 for the early postoperative management of patients with type 2 diabetes mellitus (T2D) undergoing coronary artery bypass graft (CABG) surgery.

Methods: A total of 239 patients were randomly assigned (1:1) to receive a basal-bolus regimen in the early postoperative period using degludec U100 (n = 122) or glargine U300 (n = 117) as basal and glulisine before meals. The primary outcome was mean differences between groups in their daily BG concentrations. The major safety outcome was the occurrence of hypoglycemia.

Results: There were no differences in mean daily BG concentrations (157 vs. 162 mg/dl), mean percentage of readings within target BG of 70-180 mg/dl (74% vs. 73%), daily basal insulin dose (19 vs. 21 units/day), length of stay (median [IQR]: 9 vs. 9 days), or hospital complications (21.3% vs. 21.4%) between treatment groups. There were no differences in the proportion of patients with BG <70 mg/dl (15.6% vs. 23.1%) or <54 mg/dl (1.6% vs. 4.3%) between degludec-100 and glargine-300 groups.

Conclusions: Treatment with degludec U100 is as effective and safe as glargine U300 for the early postoperative hospital management of patients with T2D undergoing CABG.

Keywords: continuous glucose monitoring system; degludec U100; glargine U300; hospital care; hypoglycemia; inpatient management.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Glucose
  • Coronary Artery Bypass
  • Diabetes Mellitus, Type 2* / drug therapy
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Insulin Glargine / adverse effects
  • Postoperative Period

Substances

  • Insulin Glargine
  • insulin degludec
  • Hypoglycemic Agents
  • Blood Glucose