[일반원칙]
구 분	현 행	개 정(안)	사유
당뇨병용제 일반원칙	(생략) 나. Insulin 요법 1) ~2) (생략) 3) Insulin degludec과 속효성 insulin 병용투여시 insulin degludec의 약값 전액은 환자가 부담함. (생략)	(현행과 같음) 나. Insulin 요법 1) ~2) (현행과 같음) <삭제> (현행과 같음)	허가사항에서 투여시간 탄력성(최소 8시간)이 있어 투여가 용이하며, 임상문헌에서 야간 저혈당 발생이 유의미하게 감소한 점 등을 고려하여, 제 2형 당뇨 환자에서 속효성 인슐린과 병용투여시 급여 인정함.
※ 관련근거 · Harrison's Principles of Internal Medicine, 19e · Diabetes management in primary care, 2e (2012) · Standards of Medical Care in Diabetes, Amerian Diabetes Assocations (2016) · 당뇨병 진료지침, 대한당뇨병학회 (2015) · Hollander P, et al. Insulin degludec improves long-term glycaemic control similarly to insulin glargine but with fewer hypoglycaemic episodes in patients with advanced type 2 diabetes on basal-bolus insulin therapy. Diabetes, obesity and metabolism 2015;17:202-6 · Garber AJ, et al. Insulin degludec, an ultra-longacting basal insulin, versus insulin glargine in basal-bolus treatment with mealtime insulin aspart in type 2 diabetes (BEGIN Basal-Bolus type 2): a phase 3, tandomised, open-label, treat-to target non-infetiortiry trial. Lancet 2012;379:1498-507 · Vora J, et al. Insulin degludec versus insulin glargine in type 1 and type 2 diabetes mellitus: a meta-analysis of endpoints in phase 3a trials. Diabetes Ther. 2014;5:435-46 · Riddle MC, et al. One-year sustained glycaemic control and less hypoglycaemia with new insulin glargine 300 U/ml compared with 100 U/ml in people with type 2 diabetes using basal plus meal-time insulin: the EDITION 1 12-month randomized trial, including 6-month extension Diabetes, Obesity and Metabolism. 2015;17:835-42 · Riddle MC, et al. New insulin glargine 300 units/mL versus glargine 100 units/mL in people with type 2 diabetes using basal and mealtime insulin: glucose control and hypoglycemia in a 6-month randomized controlled trials(EDITION1) Diabetes Care 2014;37:2755-62 · Freemantle N, et al. Safety and efficacy of insulin glargine 300 u/mL compared with other basal insulin therapies in patients with type 2 diabetes mellitus: a network meta-analysis. BMJ Open 2016;6:e009421. doi:10.1136/bmjopen-2015-009421

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