High- vs low-strength insulin glargine tied to fewer hypoglycaemic events

Insulin glargine at 300 U/mL (Gla-300) affords similar glycaemic control as that at 100 U/mL (Gla-100) in East Asian patients, although the former is associated with consistently fewer hypoglycaemic events at any time of the day and night, according to the results of a meta-analysis.

The patient-level meta-analysis was based on three EDITION studies having similar design and endpoints. The overall population comprised 547 patients treated with Gla-300 and 348 patients treated with Gla-100.

Pooled data showed that over a treatment period of 6 months, the change in glycated haemoglobin (HbA1c) from baseline did not differ between Gla-300 (least square [LS] mean, –1.13 percent) and Gla-100 (–1.14 percent), with the high-strength formulation showing noninferiority to Gla-100 (LS mean difference, 0.02 percent, 95 percent confidence interval [CI], –0.08 to 0.11).

The HbA1c target of <7.0 percent at month 6 was met by 46.4 percent (248/535) of patients in the Gla-300 group and 43.1 percent (147/341) in the Gla-100 group, with 42.4 percent and 37.0 percent having achieved this without hypoglycaemia (confirmed <3 mmol/l or severe). A similar pattern of results was observed among patients achieving HbA1c target of <6.5 percent.

Meanwhile, Gla-300 led to a consistently lower occurrence of hypoglycaemic event (confirmed ≤3.9 mmol/L or severe) at any time of day or at night (00:00 to 05:59 h) relative to Gla-100. The respective event rates of hypoglycaemia were 66.6 percent vs 74.0 percent (relative risk [RR], 0.90, 95 percent CI, 0.83–0.98) over 24 hours and 34.5 percent vs 44.5 percent (RR, 0.76, 95 percent CI, 0.64–0.90) at night.

Severe hypoglycaemia occurred rarely overall, and weight gain was minimal.