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

Ruiqing Dong,1,* Lifan Gu,2,* Heping Li,1 Yuanna Hu,3 Hui Liu,4 Xuna Kou,1 Yukun Zhao,1 Meng Zhao,1 Bingyin Shi,1 Hui Guo,1 Wei Qiang1 1Department of Endocrinology and Metabolism, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710061, People’s Republic of China; 2School of Future Technology, Xi’an Jiaotong University, Xi’an, 710049, People’s Republic of China; 3Department of Pain, The First Affiliated Hospital of Xinjiang Medical University, Urumqi City, 830017, People’s Republic of China; 4Biobank, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710061, People’s Republic of China*These authors contributed equally to this articleCorrespondence: Hui Guo, Department of Endocrinology and Metabolism, The First Affiliated Hospital of Xi’an Jiaotong University, No. 277 Yanta West Road, Xi’an, Shaanxi, 710061, People’s Republic of China, Tel/Fax +86-29-85323974, Email nfmguohui0709@xjtufh.edu.cn Wei Qiang, Department of Endocrinology and Metabolism, The First Affiliated Hospital of Xi’an Jiaotong University, No. 277 Yanta West Road, Xi’an, Shaanxi, 710061, People’s Republic of China, Tel/Fax +86-29-85323974, Email weiqiang@xjtufh.edu.cnBackground: 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