ON BEHALF OF THE NN1250-3668

OBJECTIVEdThe requirement to inject current basal insulin analogs at a fixed time each daymay complicate adherence and compromise glycemic control. This trial evaluated the efficacy and safety of varying the daily injection time of insulin degludec (IDeg), an ultra-long-acting basal insulin. RESEARCH DESIGN ANDMETHODSdThis 26-week, open-label, treat-to-target trial en-rolled adults ($18 years) with type 2 diabetes who were either insulin naïve and receiving oral anti-diabetic drugs (OADs) (HbA1c = 7–11%) or previously on basal insulin6OAD(s) (HbA1c = 7–10%). Participants were randomized to 1) once-daily (OD) IDeg in a prespecified dosing schedule, creating 8–40-h intervals between injections (IDeg OD Flex; n = 229); 2) once-daily IDeg at the main evening meal (IDegOD;n=228); or3) once-daily insulin glargine at the same time eachday (IGlarOD; n=230). Theprimaryoutcomewasnoninferiorityof IDegODFlex to IGlarOD inHbA1c reduction after 26weeks. RESULTSdAfter 26 weeks, IDeg OD Flex, IDeg OD, and IGlar OD improved HbA1c by 1.28, 1.07, and 1.26 % points, respectively (estimated treatment difference [IDeg OD Flex 2 IGlar OD]: 0.04 % points [–0.12 to 0.20], confirming noninferiority). No statistically significant differ-ences in overall or nocturnal hypoglycemia were found between IDeg OD Flex and IGlar OD. Comparable glycemic control and rates of hypoglycemia were seen with IDeg OD Flex and IDe