Jang HN, Yang YS, Oh TJ, et al. - In patients with a fasting plasma glucose (FPG) lower than predicted by glycated hemoglobin (HbA1c), insulin degludec/aspart (IDegAsp) was more effective than basal insulin, which could be related to insulin deficiency and postprandial hyperglycemia in patients on basal insulin therapy.

• It was a retrospective observational study.

• Patients were recruited who initiated once-daily IDegAsp from a basal insulin cohort from three referral hospitals.

• There were 87 patients in the IDegAsp group and 87 participants in the control group.

• The two groups had similar baseline HbA1c levels (8.7 ± 0.9 vs 8.6 ± 0.9%, mean and standard deviation).

• HbA1c in the IDegAsp group was lower than in the control group (8.1 ± 1.0 vs 8.4 ± 1.1%) after 6 months of matched insulin doses.

• FPG and fasting C-peptide were both lower in the IDegAsp than in the control group (FPG 124.2 ± 38.4 vs 148.0 ± 50.6 mg/dL).

• Subgroup analysis was performed using a ratio of FPG-to-estimated average glucose, which is determined from HbA1c because the reduced FPG despite comparable HbA1c could be connected to the efficacy of IDegAsp.

• The superiority of IDegAsp in reducing HbA1c was significant only in patients with a lower FPG-to-estimated average glucose ratio, but not in those with a greater FPG-to-estimated average glucose ratio, as compared with each control group.