Manila, Philippines, 29 August 2015 – Almost 85% of Filipino diabetes patients do not reach optimal control of their diabetes, which results in many severe long term effects.1 One of the primary reasons for not reaching optimal glycemic control is low blood sugar or hypoglycemic event especially the ones occurring at night. Night-time low blood sugar or nocturnal hypoglycemia affects nearly half of adults with type 1 diabetes, and 1 in 3 people with type 2 diabetes.1 The most common symptoms are difficulty waking up, night sweats, waking with a headache, waking up tired despite a full night’s sleep, nightmares, and talking during sleep. In severe cases, nocturnal hypoglycemia can cause coma, seizures, brain damage and death.2,3 Nocturnal hypoglycemia is unpredictable and difficult to detect.4 Research has shown that fears and concerns about hypoglycemia can interfere with achieving optimal glycemic control among people with diabetes using insulin.5,6
In the hope of addressing these barriers for patients, Novo Nordisk has developed a novel basal insulin with proven efficacy and a lower risk of nocturnal hypoglycemia. Insulin degludec is a once-daily basal insulin for people with diabetes that successfully achieves reductions in blood glucose levels, with a lower risk of nocturnal hypoglycemia versus insulin glargine. 7 It allows for flexibility in day-to-day dosing time, when needed without compromising efficacy or risk of hypoglycaemia. 7,8
Results from studies over a two-year period show insulin degludec successfully achieves equivalent reductions in HbA1c, and with a lower risk of nocturnal hypoglycemia compared to insulin glargine: 43% for people with type 2 diabetes9 and 25% for people with type 1 diabetes10.
“Maintaining good blood glucose control with insulin treatment can be challenging for healthcare professionals and patients due to concerns over hypoglycemia and night-time hypoglycemia in particular. Insulin degludec has shown less risk of nocturnal hypoglycemia than the most widely used basal insulin,” said Prof. Gregory Fulcher, Senior Staff Specialist at Royal North Shore Hospital and Clinical Professor of Medicine at the University of Sydney in Australia.
Addressing adherence to day-to-day dosing
A daily routine is recommended for insulin users but because of insulin degludec’s ultra-long duration of action of up to 42 hours, it allows flexibility in dosing which may benefit patients who find it challenging to always inject insulin at the same time each day. 11, 12
“Insulin degludec can be administered at any time of the day, offering flexible dosing schedule when needed. This flexibility could help improve the lives of patients, as poor insulin adherence contributes to poor glycemic control,” said Prof. Masato Odawara of the Department of Diabetology, Metabolism, and Endocrinology, Tokyo Medical University in Japan.
“Adherence to fixed dosing schedule is one of the challenges that many of our Filipino patients encounter, and this barrier can now be addressed with the help of insulin degludec,” added Dr. Rima Tan, President of Diabetes Philippines.
“Insulin degludec can potentially help Filipino patients achieve optimal glycemic control and prevent serious diabetes complications such as heart disease, stroke, blindness, kidney disease, nerve damage and premature mortality,” said Dr. Sjoberg Kho, Chief of Section, Endocrinology, Diabetes and Metabolism at University of Santo Tomas Hospital.
The four diabetes experts spoke during the 2-day launch of insulin degludec on August 28 and 29, 2015 at the Makati Shangri La Hotel, Makati City.
Nicole Braham, a Type 1 Diabetes patient also shared her experience, “I am very happy to say that with Insulin degludec, I have experienced less nighttime hypoglycemia, and my overall quality of life has improved. I am now able to travel alone. Life is better for me and for my family.”
Ranked in the top 15 in the world for diabetes prevalence, the Philippines is one of the world’s emerging diabetes hotspots. There are over 4 million Filipinos diagnosed with type 2 diabetes—and a worryingly large unknown number who are unaware they have diabetes, according to the International Diabetes Federation.13
“We are pleased to make another Novo Nordisk breakthrough in diabetes management available to Filipino patients. Insulin degludec has been studied in a large-scale clinical trial, which demonstrated its positive impact on glucose control, hypoglycemia and flexibility in day-to-day dosing time when needed,” said Mr. Jeppe Theisen, General Manager, Novo Nordisk Philippines.
- Cecilia A. Jimeno, MD, et al. DiabCare 2008: Survey on Glycaemic Control and the Status of Diabetes Care and Complications Among Patients with Type 2 Diabetes Mellitus in the Philippines. Phil J of Int Medicine. Volume 50. No.1 2012.
- World Awake – Nocturnal Hypoglycemia backgrounder
- American Diabetes Association. Common terms: hypoglycemia. Available at: http://www.diabetes.org/diabetes-basics/common-terms/common-terms-f-k.html Last accessed August 2014.
- American Diabetes Association Working Group on Hypoglycemia. Defining and reporting hypoglycemia in diabetes. Diabetes Care. 2005;28:1245-9.
- Allen KV, et al. Nocturnal hypoglycaemia: clinical manifestations and therapeutic strategies toward prevention. Endocr Pract. 2003;9:530-43
- Leiter L, et al. Assessment of the impact of fear of hypoglycemic episodes on glycemic and hypoglycemia management. Can J Diabetes. 2005;29:186-92.
- Tresiba® Summary of Product Characteristics (SPC). Bagsværd, Denmark, Novo Nordisk A/S; June 2014.
- Mathieu C, et al. Efficacy and safety of insulin degludec in a flexible dosing regimen vs insulin glargine in patients with type 1 diabetes (BEGIN: Flex T1): a 26-week randomized, treat-to-target trial with a 26-week extension. J Clin Endocrinol Metab. 2013;98:1154-62.
- Rodbard H, et al. Comparison of insulin degludec with insulin glargine in insulin-naive subjects with type 2 diabetes: a 2-year randomized, treat-to-target trial. Diabet Med. 2013;30:1298-1304.
- Bode B, et al. Insulin degludec improves glycaemic control with lower nocturnal hypoglycaemia risk than insulin glargine in basal–bolus treatment with mealtime insulin aspart in Type 1 diabetes (BEGIN Basal–Bolus Type 1): 2-year results of a randomized clinical trial. Diabet Med. 2013;30:1293–7.
- Meneghini LF, Miranda-Palma B. Insulin degludec: a novel ultra-long-acting basal insulin for use in type 1 and 2 diabetes. Expert Rev Endocrinol Metab 2012; 7(1):9-14.
- Khunti K, Cos X, Rutten G Insulin degludec: The impact of new basal insulin on care of type 2 diabetes. Primary Care Diabetes 2014; 7(8):119-1125.