Objective: To evaluate the impact of insulin degludec/insulin aspart (IDegAsp) treatment on healthcare resource utilization (HRU) in adults with type 2 diabetes (T2D).

Methods: This was a 26-week, open-label, non-interventional study (NCT04042441) conducted in six countries across three continents. Data were prospectively collected from 1102 people with T2D initiating or switching to IDegAsp from any antidiabetic treatment per local clinical practice. Country cohort sizes ranged from 179 to 188 participants. Change in A1c from baseline to end of study (EOS, first visit from week 26–36) was the primary outcome. Incidence of severe hypoglycemia was a secondary outcome. Self-reported HRU associated with management of diabetes/relevant complications occurring within 12 weeks before IDegAsp initiation and equivalent before EOS/discontinuation (exploratory outcome) was analyzed via negative binomial regression model.

Results: There was significant improvement in A1c from baseline to EOS (estimated change: −1.4% [−1.51;−1.29]_{95% CI}; p<0.0001). Overall incidence rate of severe hypoglycemia decreased significantly between the 26-week period before baseline and the equivalent before EOS (estimated rate ratio [RR]: 0.06 [0.02;0.24]_{95% CI}; p<0.0001). Overall, 510 participants reported HRU before IDegAsp initiation. There were significant reductions from baseline to EOS in outpatient visits (RR: 0.44 [0.35;0.54]_{95% CI}; p<0.0001), emergency room visits (RR: 0.22 [0.11;0.44]_{95% CI}; p<0.0001), in-patient hospitalizations (RR: 0.24 [0.14;0.41]_{95% CI}; p<0.0001) and workdays missed (RR: 0.06 [0.03;0.14]_{95% CI}, p<0.0001), with similar trends observed across countries (data not shown). No significant change was reported in other healthcare provider visits. Country-specific numbers of total HRU events ranged from 123 to 1224. Number of total HRU events was higher in insulin-experienced participants (2061) than insulin-naïve participants (1129).

Conclusions: IDegAsp treatment was associated with improved glycemic control, lower severe hypoglycemia rates and reduced HRU in adults with T2D in a real-world setting. IDegAsp treatment may produce societal benefits through reduced work loss and healthcare provider costs.