Outcomes of glycemic control in type 1 diabetic patients switched from basal insulin glargine 100 U/ml to glargine 300 U/ml in real life

ABSTRACT

Aims: The objective of this study was to evaluate glycemic control in type 1 diabetic mellitus patients who were switched from glargine 100 U/ml (Gla-100) to glargine 300 U/ml (Gla-300) in real life practice.

Methods: Glycemia based on self-monitoring capillary blood glucose, hypoglycemic events and insulin doses were considered during a two-week period before and after transition from Gla-100 to Gla-300 (period 1). Glycated hemoglobin A1c (HbA_1c) levels, basal insulin doses and weight were also determined at 12 and 24 weeks after switching (period 2).

Results: 116 patients treated with a basal prandial insulin scheme were included. 72% received one injection and 28% two daily injections of Gla-100 before transition to Gla-300. Glycemic control was similar during period 1 . In contrast, the number of nocturnal hypoglycemic events were significantly reduced [22.2% vs 12.2%; relative risk 0.46 (95% CI 0.30 – 0.68); p < 0.0001], as well as the number of patients with nocturnal hypoglycemia per period [30% vs 16%; relative risk 0.53 (95% CI 0.31–0.86); p < 0.01]. At the end of period 2, HbA_1c decreased from 8.0 ± 1.0% (65.5 ± 10.5 mmol/mol) to 7.9 ± 1.0% (62.8 ± 10 mmol/mol) (p = 0.03). Insulin doses of Gla-300 were increased in patients treated previously with Gla-100 (+6.5%), but no weight gain was observed.

Conclusion: Short term glycemic control was comparable in patients treated with basal insulin Gla-100 or Gla-300 injection. Nocturnal hypoglycemic rate declined quickly after the switch. HbA_1c was reduced after six months of Gla-300 treatment versus baseline. Gla-300 doses were moderately higher (vs Gla-100), in particular, in patients treated with one Gla-100 dose before switching. Gla-300 is an alternative therapeutic option of interest.

KEYWORDS:

• Type 1 diabetes
• switch
• glargine 100U/ml
• glargine 300 U/ml
• glycemic control
• hypoglycemia
• weight
• insulin doses

Acknowledgments

The authors thank the diabetes educator staff for participating in this study.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

PO conceived and designed this study and collected patients. JW validated the biological data of the study. PO and MB drafted the manuscript.

Additional information

Funding

This manuscript was not funded.