Successful glycemic control with three times a week degludec injection by medical staff for an elderly hemodialysis patient with type 2 diabetes.

For elderly hemodialysis patients with diabetes, the treatment options are restricted, and insulin therapy plays an important role. However, sometimes it might be difficult for them to inject insulin by themselves because of technical and/or social problems. The recently introduced basal insulin analog degludec has a longer half life than the previous basal insulin analogs such as glargine or detemir. Here we report an elderly hemodialysis patient with type 2 diabetes who was successfully treated with insulin degludec injection by the medical staff at every hemodialysis clinic visit. Throughout this treatment, he did not experience any side effects due to degludec, including hypoglycemia. There are few reports of using degludec for HD patients. In addition, this is the first report showing the validity of a three-times-a-week degludec regimen as a basal supported oral therapy for a hemodialysis patient with diabetes who could not inject insulin by himself. The inferiority of the three-times-a-week degludec regimen compared with the once-a-day glargine regimen in non-hemodialysis patients has already been reported. Based on this, this three-times-a-week degludec regimen should also not be considered as a standard regimen in hemodialysis patients. However, this three-times-a-week degludec regimen may be useful as an alternative for hemodialysis patients who cannot inject insulin once a day by themselves to achieve good and safe glycemic control, improving the prognosis and avoiding problems with hyperglycemia.