Transition from Continuous Subcutaneous Insulin Infusion to IDeg-Based Regimens in Hospitalized T2DM Patients: A Single-Center Retrospective Analysis

Background: Chinese patients with type 2 diabetes mellitus (T2DM) often initiate insulin therapy in the hospital, requiring rapid glycemic control and simplified post-discharge plans. Few clinical studies have focused on the transition protocols for continuous subcutaneous insulin infusion (CSII). Objective: To evaluate the efficacy, safety, and patient satisfaction of transitioning from CSII to three treatment regimens: insulin degludec (IDeg), insulin degludec/insulin aspart (IDegAsp), or insulin degludec and liraglutide (IDegLira). Methods: Clinical information and continuous glucose monitoring (CGM) data were retrospectively collected from 171 patients in a single center. Patient satisfaction and quality of life were assessed using standardized questionnaires in a three-month follow-up. Results: After transition, mean glucose (MG) and glucose management indicator (GMI) decreased, while time in range (TIR) increased significantly. Coefficient of variation (CV) and time above range (TAR) decreased. Time below range (TBR) was unchanged in IDegAsp and IDegLira groups but slightly increased in the IDeg group (0.60% [0.00%, 1.60%] vs 1.10% [0.00%, 3.40%], P = 0.003). IDegAsp and IDegLira groups showed higher TIR and lower MG, GMI, CV, TAR, and TBR. 64.3% of IDegLira patients required one or fewer additional medications. Patient satisfaction was highest in the IDegLira group, with hypoglycemia avoidance, better weight management, fatigue prevention and less anxiety. Conclusion: All three regimens enabled a smooth transition after CSII therapy. IDegAsp and IDegLira demonstrated superior glycemic control and reduced variability compared to IDeg. IDegLira was more convenient and associated with higher patient satisfaction. Keywords: type 2 diabetes mellitus, insulin degludec, insulin degludec/insulin aspart, insulin degludec and liraglutide, continuous glucose monitoring