Glargine, degludec improve glycaemic control in patients switching from first-gen insulin

Among type 2 diabetes (T2D) patients on first-generation basal insulins (1BIs), a switch to either glargine or degludec in the real-world setting leads to marked improvements in glucose control without increasing the risk of hypoglycaemic events and weight gain, according to a study. Furthermore, the benefits seem to be comparable between the two second-generation basal insulins (2BIs).

Researchers looked at the medical records of Italian patients with T2D who were switching from a 1BI to a 2BI. They used propensity score to match patients switching to glargine 300 U/mL (Gla-300; n=539) to those switching to degludec 100 U/mL (Deg-100; n=539).

Estimated mean levels of HbA1c at baseline was about 8.7 percent in both groups. HbA1c levels decreased significantly during 6 months of follow-up: by –0.58 percent (95 percent confidence interval [CI], –0.69 to –0.47) in the Gla-300 group and by –0.50 percent (95 percent CI, –0.61 to –0.39) in the Deg-100 group. The between-group difference of –0.08 did not reach statistical significance, establishing the noninferiority of Gla-300 over Deg-100.

Fasting blood glucose also decreased by about 20 mg/dl in both groups.

The mean dose of 2BI was suboptimally titrated during follow-up, while body weight was relatively unchanged in both groups.

Hypoglycaemia (<54 mg/dL) occurred at an incidence rate of 0.32 (95 percent CI, 0.21–0.49) per patient-month in the Gla-300 group vs 0.19 (95 percent CI, 0.11–0.33) in the Deg-100 group (p=0.14).