Insulin glargine, degludec yield comparable effects on glycaemic control

In patients with of type 2 diabetes (T2D), glargine 300 U/mL (Gla-300) and degludec 100 U/mL (Deg-100) deliver similar improvements in glycaemic control, without increasing weight and hypoglycaemic events over 6 months of treatment, according to data from the retrospective RESTORE-2 NAIVE study.

Researchers looked at 1,166 T2D patients who were insulin-naïve with first prescription of second-generation basal insulin analogues (808 initiating Gla-300 and 358 initiating Deg-100). Prior to propensity score (PS) matching, patient characteristics were balanced between groups, except for the use of secretagogues (42.6 percent vs 50.0 percent; p=0.02), glitazones (5.9 percent vs 11.2 percent; p=0.002), and sodium-glucose transport protein 2 (SGLT2) inhibitors (27.5 percent vs 19.6 percent; p=0.004).

After PS matching, 357 participants were included in each group. At baseline, both groups had mean HbA_1c of about 9.2 percent. The mean follow-up time was similar in the Gla-300 and Deg-100 groups (6.4 vs 6.6 months), as was the mean number of visits per patient over 6 months (3.0 vs 3.0).

At month 6, the primary endpoint of HbA_1c decreased significantly in both the Gla-300 and Deg-100 groups (−1.70 percent vs −1.69 percent; p=0.49), confirming the noninferiority of Gla-300 vs Deg-100.

Similar improvements were also seen for fasting blood glucose (~60 mg/dl in both groups), with body weight remaining unchanged. In both groups, the mean starting dose was 12 U and slightly titrated to 16 U.

Incidence rates of hypoglycaemia (≤70 mg/dl and <54 mg/dL) were also comparable, being 0.13 and 0.02 episodes per patient-months in the Gla-300 group and 0.14 and 0.02 episodes per patient-months in the Deg-100 group (p=0.87 and p=0.49, respectively). There were no reports of severe hypoglycaemia.