Diabetic patients require similar basal insulin dose upon conversion to Basaglar

Patients with diabetes who switch to Basaglar need similar basal insulin doses, according to a study.

“Several basal insulins have recently come to market including follow-on insulin glargine,” the authors said. “Currently, there is no real-world data published on the implications of conversion to Basaglar on dosing or glycaemic control.”

To address this, they sought to determine the differences in basal insulin dosing requirements, haemoglobin A1c (HbA1c), and incidence of hypoglycaemia or weight gain when converting a patient to Basaglar from another basal insulin.

This single-centre, retrospective cohort chart review was conducted at an academic medical centre. The authors included for review all patients prescribed Basaglar between 15 December 2016 and 31 August 2017 if they converted from another basal insulin.

The primary outcome was the difference in basal insulin requirements in both units/d and units/kg after conversion to Basaglar. Secondary outcomes included change in HbA1c and weight.

Mean basal insulin dose pre- and postconversion was 38.4±26.3 and 40.5±29.8 units/d, respectively (p=0.031). Results were significant for patients with type 2 diabetes mellitus (T2DM; precoversion basal dose 34.6±24.3 units/d; postconversion basal dose 37.6±29.0 units/d; p=0.009).

For weight-based dosing, the preconversion dose of 0.37±0.25 units/kg/d slightly rose to 0.39±0.29 units/kg/d postconversion (p=0.056). This change was significant for those with T2DM (p=0.040).

Furthermore, there was a nonsignificant decrease in HbA1c (–0.14±1.24 percent; p=0.142) and no difference in weight (111.6±46.3 vs 111.7±46.9 kg; p=0.662).

“Clinicians should monitor blood glucose closely during basal insulin transition,” the authors said.