Reduced hypoglycemia risk in type 2 diabetes patients switched to/initiating insulin glargine 300 vs 100 U/ml: A european real-world study

Introduction: Randomized controlled trials and real-world data from the USA have shown similar glycemic control with insulin glargine 300 U/ml (Gla-300) and insulin glargine 100 U/ml (Gla-100) and reduced hypoglycemia risk with Gla-300. This real-world study describes the efficacy and safety of Gla-...

Descripción completa

Detalles Bibliográficos
Autores: Escalada, J. (Javier)|||/items/49a6b2d2-0f66-4005-b584-099f1728e80b, Bonnet, F. (Fabrice)|||/items/f96c2412-b6d2-4d27-9884-15567af9fe08, Wu, J. (Jasmanda)|||/items/b7da06dc-2d37-4f4f-8946-07e7b6658248, Bonnemaire, M. (Mireille)|||/items/dd7059fc-7c98-4927-b5a2-d322a85b24dc, Gupta, S. (Shaloo)|||/items/64bb14b2-d4c8-4276-9b2b-70b55a836e26, Cambron-Mellott, J.M. (Janelle M.)|||/items/f9db40c0-5b6b-43f2-a4f6-3297cc433e2f, Nicholls, C. (Charlie)|||/items/b49d6794-7247-4f22-aead-c7a64b63a474
Tipo de recurso: artículo
Fecha de publicación:2020
País:España
Institución:Universidad de Navarra
Repositorio:Dadun. Depósito Académico Digital de la Universidad de Navarra
Idioma:inglés
OAI Identifier:oai:dadun.unav.edu:10171/67788
Acceso en línea:https://hdl.handle.net/10171/67788
Access Level:acceso abierto
Palabra clave:Diabetes mellitus
Hypoglycemia
Insulin glargine
Type 2
Descripción
Sumario:Introduction: Randomized controlled trials and real-world data from the USA have shown similar glycemic control with insulin glargine 300 U/ml (Gla-300) and insulin glargine 100 U/ml (Gla-100) and reduced hypoglycemia risk with Gla-300. This real-world study describes the efficacy and safety of Gla-300 and Gla-100 in patients with type 2 diabetes (T2D) in France, Spain, and Germany. Methods: This retrospective chart review analysis used anonymized data for adults with T2D switching basal insulin analog (BIA) therapy to Gla-300 or Gla-100, or insulin-naïve patients initiating Gla-300 or Gla-100. Outcomes included change from baseline to 6-month follow-up in glycated hemoglobin A1c (A1C), total and severe hypoglycemia incidences and events, insulin dose, and reasons for BIA choice. Results: Six hundred sixty-five physicians (33.8% Spain, 31.7% France, 34.4% Germany) provided chart data for patients switching to Gla-300 (n = 679) or Gla-100 (n = 429) or initiating Gla-300 (n = 719) or Gla-100 (n = 711). After adjustment for baseline characteristics, A1C reductions from baseline were similar for patients switching to Gla-300 or Gla-100 (- 0.87% vs. - 0.93%; p = 0.326) while those switched to Gla-300 vs. Gla-100 had a significantly greater mean reduction in hypoglycemic events (- 1.29 vs. - 0.81 events during 6 months; p = 0.012). Mean insulin doses after titration were 0.43 ± 0.36 and 0.40 ± 0.28 U/kg in Gla-300 and Gla-100 switchers, respectively. Factors that significantly influenced BIA choice included a lower risk of hypoglycemia (for Gla-300) and physician familiarity (for Gla-100). Outcomes for insulin-naïve patients were broadly similar to those of switchers. Conclusions: In this real-world European study, patients with T2D who switched therapy to Gla-300 or Gla-100 had improved glycemic control and reduced hypoglycemia at 6 months, with significant hypoglycemia advantages with Gla-300.