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Insulin degludec, an ultralong-acting insulin with an elimination half-life of 25 hours, was FDA-approved in 2015. Three new randomized double-blind trials, sponsored by degludec's manufacturer, compare rates of hypoglycemia and adverse cardiovascular (CV) events with insulin degludec and insulin glargine (elimination half-life, ≈12 hours).
A crossover trial addressed hypoglycemia in 501 type 1 diabetic adults who were on basal-bolus insulin regimens and considered at above-average risk for hypoglycemia. Patients received 32 weeks of degludec and 32 weeks of glargine U100, in random order, with insulins adjusted to achieve a fasting glucose target of 71 to 90 mg/dL. The rate of symptomatic hypoglycemia was modestly but significantly lower wi…