3 Results 3.1 Patient Characteristics Five of the seven patients included in this study were diagnosed as having T1DM by the detection of islet-associated autoantibodies, and the other two cases by their medical history. In all cases, ad libitum CPR levels were less than 0.03 ng/mL (not detectable). The clinical characteristics of the patients are shown in Table 2. The mean age (± standard deviation) was 51.9 ± 16.6 years, HbA1c was 7.3 ± 0.9 %, and the body mass index was 21.3 ± 2.9 kg/m2. TDD was 0.71 ± 0.40 U/kg and total daily basal insulin dose (TBD) was 0.32 ± 0.17 U/kg. The ratio of TBD to TDD (TBD/TDD)

was 44.8 ± 12.8 %. Insulin glargine was used as the basal insulin preparation in six of seven patients. As AZ 628 mouse supplemental insulin, ultra-rapid-acting insulin was used in all patients, insulin lispro in two patients, and insulin aspart in five. Table 2 Characteristics of enrolled patients Variables Detemir or Glargine twice daily n 7 Crizotinib chemical structure Sex (male:female) 3:4 Age (years) 51.9 ± 16.6 HbA1c (%, NGSP) 7.3 ± 0.9 BMI (kg/m2) 21.3 ± 2.9 Duration of diabetes mellitus (years) 13.7 ± 6.5 Glargine (number of cases) 6 Detemir (number of cases) 1 TDD/Wt (U/kg) 0.71 ± 0.40 TBD/Wt (U/kg)

0.32 ± 0.17 TBD/TDD (%) 44.8 ± 12.8 Data are given as mean ± SD unless otherwise stated HbA 1c glycated hemoglobin, NGSP national glycohemoglobin standardization program, TBD total daily dose of basal insulin, TDD total daily dose of insulin, U units, Wt weight 3.2 Insulin Dose Insulin degludec was administered Bupivacaine at 80–90 % of the dose of the prior insulin, resulting in a significant decrease in

TDD from 0.71 ± 0.40 to 0.67 ± 0.39 U/kg (p = 0.02) (Fig. 2a). TBD also showed a significant decrease from 0.32 ± 0.17 to 0.27 ± 0.17 U/kg (p = 0.02) (Fig. 2b). In addition, TBD/TDD decreased significantly from 44.8 ± 12.3 to 40.7 ± 11.7 % (p = 0.02) (Fig. 2c). Significant decreases were observed with TDD, TBD, and TBD/TDD after about 24 weeks of use of insulin LOXO-101 in vitro degledec (TBD: p = 0.03, TDD: p = 0.02, TBD/TDD: p = 0.03) (Fig. 2a–c). Fig. 2 Changes in (a) TDD, (b) TBD, and (c) TBD/TDD just before, and 0 and 20–30 weeks after switching to degludec. *p < 0.05 versus baseline (glargine or detemir). Deg degludec, TBD total daily dose of basal insulin, TDD total daily dose of insulin, W week 3.3 Comparison of CGM Findings 3.3.1 Mean Daily Blood Glucose Level The mean blood glucose level showed no significant changes before and after switching from insulin glargine or detemir to insulin degludec (Fig. 3a). Fig. 3 Changes in (a) mean glucose, (b) standard deviation, (c) MAGE, and (d) AUC 0000–0600 hours versus baseline (glargine or detemir). AUC area under the blood glucose concentration–time curve, Deg degludec, MAGE mean amplitude of glycemic excursion, n.s. not significant, W week No significant changes were also observed with the standard deviation (Fig. 3b) and mean amplitude of glycemic excursion (MAGE) (Fig. 3c) throughout the study period.