Clinical Outcomes of Switching to Insulin Glargine 300 U/ml from Other Basal Insulins in People with Type 2 Diabetes in
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ORIGINAL RESEARCH
Clinical Outcomes of Switching to Insulin Glargine 300 U/ml from Other Basal Insulins in People with Type 2 Diabetes in Italy: A Real-World Study Mauro Ragonese . Monica Larosa . Stefania Angotti . Stefania Annese . Laura Cruciani . Michela Dainelli . Giuseppe Lucisano . Giuseppe Prosperini . Michele Sacco . Enrica Salomone . Caterina Saponara . Roberta Semprini . Maria Chiara Rossi . Antonio Nicolucci Received: June 18, 2020 The Author(s) 2020
ABSTRACT Introduction: Primary aim was to provide realworld evidence of the outcomes after the switch to glargine 300 U/ml (Gla-300) from other basal insulins (first or second generation) in Italy. Methods: Multicenter, observational, retrospective study based on electronic medical records. Results: Overall, 953 T2DM insulin ± OAD treated people switched to Gla-300 or Gla-100 from January 2015 to July 2018. Three clinically relevant cohorts were identified: patients switching to Gla-300 from first-generation basal insulin (cohort 1), patients switching to Gla-300 from degludec-100 (Deg-100) (cohort 2), and those switching to Gla-100 from any basal insulin (cohort 3). The three cohorts differed in terms of age, diabetes duration, and metabolic Digital Features To view digital features for this article go to: https://doi.org/10.6084/m9.figshare.12732233. M. Ragonese S. Angotti S. Annese L. Cruciani M. Dainelli E. Salomone C. Saponara R. Semprini ACISMOM-UOC Attivita` Ambulatoriale, Rome, Italy M. Larosa Sanofi SpA, Medical Affairs, Milan, Italy G. Lucisano G. Prosperini M. Sacco M. C. Rossi A. Nicolucci (&) CORESEARCH-Center for Outcome Research and Clinical Epidemiology, Pescara, Italy e-mail: [email protected]
control. HbA1c changes after 6 months from the switch were - 0.27% (95% CI - 0.38; - 0.16), - 0.06% (95% CI - 0.31; 0.19), and - 0.30% (95% CI - 0.51; - 0.09) in the three cohorts, respectively. FPG significantly decreased in cohort 1 (- 14.07 mg/dl, 95% CI - 20.25; - 7.89), while body weight significantly decreased in cohort 2 (- 1.47 kg, 95% CI - 2.55; - 0.39). Doses of insulin marginally changed during the follow-up (? 0.89 U in basal insulin daily dose in cohort 1 and ? 2.07 U in short-acting insulin daily dose in cohort 2). Conclusions: Switching to Gla-300 from firstgeneration basal insulin in the real world is associated with improvements in metabolic control despite a suboptimal titration of both basal and short-acting insulins. Inertia in insulin titration documented in the Gla-100 cohort is also observed with the second-generation basal insulin. The switch to Gla-300 from Deg100 was associated with a decrease in body weight of - 1.47 kg despite a slight increase in short-acting insulin daily doses of about ? 2 U. Keywords: Basal insulin; Degludec; Glargine 100; Glargine 300; Switch; Type 2 diabetes
Diabetes Ther
Key Summary Points Why carry out this study? Second generation basal insulins provide similar or improved efficacy compared to first generation ones with better safety profile. Real world evidence
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