Comparative effectiveness of Glargine 300 U/mL vs. Degludec 100 U/mL in patients with type 2 diabetes switching from 1° generation basal insulins

Autor: Raffaella Buzzetti, Gian Paolo Fadini, Antonio Nicolucci, Monica Larosa, Maria Chiara Rossi, Domenico Cucinotta, Gabellieri Enrico, Alpestre Mauro, Marangoni Alberto, Bassano del Grappa, Pagotto Uberto, Bongiorno Claudio, Gatta Concetta, Del Buono Andrea, Lamacchia Olga, Maiellaro Pasquale, Antenucci Daniela, Brandoni Gabriele, Borroni Francesca, Gregori Giovanna, Di Benedetto Antonino, Placentino Giuseppe, Cavalot Franco, Barale Cristina, Fadini Gian Paolo, Del Sindaco Paola, Di Loreto Chiara, Anichini Roberto, Citro Giuseppe, D'Angelo Paola, Carletti Silvia, Buzzetti Raffaella, Sterpetti Sara, Carmen Mignogna, Elli Paolo, Giuseppe Prosperini, Michele Sacco, Giuseppe Lucisano
Rok vydání: 2022
Předmět:
Zdroj: Nutrition, metabolism, and cardiovascular diseases : NMCD. 32(9)
ISSN: 1590-3729
Popis: Data on second generation basal insulin (2BI) in people with type 2 diabetes (T2D) generated by clinical trials still need confirmation in real-world clinical settings. This study aimed at assessing the comparative effectiveness of 2BI [Glargine 300 U/mL (Gla-300) vs. Degludec 100 U/mL (Deg-100)] in T2D Italian patients switching from first generation basal insulins (1BI).This was a retrospective, non-inferiority, multicenter study. Patients switching to Gla-300 or Deg-100 from 1BI were 1:1 propensity score matched (PSM). Changes during 6 months in continuous endpoints were assessed through linear mixed models. Incidence rates (IR) of hypoglycemia (episodes per patient-months) were compared using Poisson regression. Each PSM cohort included 593 patients. HbA1c decreased from baseline (8.7%) to 6 months by -0.58% (95%CI -0.69;-0.47) in Gla-300 group and -0.50% (95%CI -0.61;-0.39) in Deg-100 group, confirming the non-inferiority of Gla-300 vs. Deg-100. No between-group differences emerged: FBG was reduced by about 20 mg/dl with both 2BI, mean dose of 2BI (24.5 U, 0.3 U/Kg at the first prescription) was suboptimally titrated during 6 months (+1.34 U in Gla-300 and + 1.76 U in Deg-100), body weight showed minor changes. IR of hypoglycemia54 mg/dl was 0.32 (95%CI 0.21; 0.49) in Gla-300 group and 0.19 (95%CI 0.11; 0.33) in Deg-100 group (p = 0.14).In subjects with T2D, switching to 2BI from 1BI was associated with similar improvements in glycemic control, low hypoglycemia rates and no weight gain in real-life setting. Clinical inertia, represented by late treatment intensification and suboptimal titration, represents a major issue in Italy.
Databáze: OpenAIRE
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