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Had a read of the NICE Guidelines - it's quite revealing...
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<blockquote data-quote="tim2000s" data-source="post: 887914" data-attributes="member: 30007"><p>On the topic of access to Degludec, there are also some interesting points.</p><p></p><p>The most effective long acting at reducing Hba1C was shown to be, on average, Detemir once or twice daily, Detemir twice daily, Glargine once daily, Detemir once daily, NPH (!) once or twice daily and then Degludec once daily. </p><p></p><p>When you read through all the results of the insulin studies, Degludec doesn't come out particularly well, as whilst it costs considerably more per person to provide, it didn't show any clinically important benefits over Glargine, where Detemir does.</p><p></p><p>In terms of ranking of insulin therapies, Insulin Detemir twice daily is ranked as the method with the most clinical benefit, at a slightly higher cost than Glargine, so I would expect to see more recommendations of this approach for therapy.</p><p></p><p>It is worth noting the final word on the topic of Basal Insulin Therapies:</p><p></p><p><strong>The GDG were unable to make a full assessment of degludec as there is currently insufficient data regarding its clinical effectiveness in comparison to other insulin regimens.</strong></p></blockquote><p></p>
[QUOTE="tim2000s, post: 887914, member: 30007"] On the topic of access to Degludec, there are also some interesting points. The most effective long acting at reducing Hba1C was shown to be, on average, Detemir once or twice daily, Detemir twice daily, Glargine once daily, Detemir once daily, NPH (!) once or twice daily and then Degludec once daily. When you read through all the results of the insulin studies, Degludec doesn't come out particularly well, as whilst it costs considerably more per person to provide, it didn't show any clinically important benefits over Glargine, where Detemir does. In terms of ranking of insulin therapies, Insulin Detemir twice daily is ranked as the method with the most clinical benefit, at a slightly higher cost than Glargine, so I would expect to see more recommendations of this approach for therapy. It is worth noting the final word on the topic of Basal Insulin Therapies: [B]The GDG were unable to make a full assessment of degludec as there is currently insufficient data regarding its clinical effectiveness in comparison to other insulin regimens.[/B] [/QUOTE]
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Type 1 Diabetes
Had a read of the NICE Guidelines - it's quite revealing...
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