Abstract
BackgroundThe uncertainties regarding dose similarities between basal long-acting insulin analogues remain. Recent real-world studies indicate dose similarities between insulin detemir and insulin glargine, but further studies are still warranted.The aim of this study was to compare real-life daily doses of insulin detemir and insulin glargine in type 2 diabetes patients when administered once daily.MethodsWe analysed 536 patient cases from general practice (63%) and endocrinological outpatient clinics (37%). A self-administered questionnaire completed by the treating physician was used to obtain data on patient characteristics (gender, age, weight, height, latest HbA1c-value), daily doses, administration of and number of years treated with insulin detemir and insulin glargine, concomitant insulin use and use of non-insulin anti-diabetic medication. Both bivariate analyses and multivariate regression analyses were applied to examine whether there were differences in the daily doses of insulin detemir and insulin glargine.ResultsThere was no significant difference in the mean daily doses of insulin detemir (0.414 U/kg) and insulin glargine (0.416 U/kg) (p = 0.4341). In multivariate regression analyses, age and BMI had a significant influence on daily insulin dose with the dose increasing 0.003 U/kg (p = 0.0375) and 0.008 U/kg (p = 0.0003) with every 1 increment in age and BMI, respectively.ConclusionsDose similarities between insulin detemir and insulin glargine were seen in type 2 diabetes patients when administered once daily. Thus, the use of insulin detemir and insulin glargine is not associated with different medical costs if the price and treating algorithm are similar.
Highlights
The uncertainties regarding dose similarities between basal long-acting insulin analogues remain
Other studies - including both clinical trials [12,13,14,15] and real-world studies [16;17] - have found that the use of DET and GLAR in Type 2 diabetes (T2D) patients results in comparable glycated hemoglobin (HbA1c) improvements and a similar low risk of hypoglycaemia versus neutral protamine Hagedorn (NPH), whereas DET is associated with significantly less weight gain than GLAR [12,13,14,15,16,17,18]
The general practitioner (GP) were asked to fill in a questionnaire for each of their T2D patients treated with either DET or GLAR based on information registered in their computer system
Summary
The uncertainties regarding dose similarities between basal long-acting insulin analogues remain. The aim of this study was to compare real-life daily doses of insulin detemir and insulin glargine in type 2 diabetes patients when administered once daily. Other studies - including both clinical trials [12,13,14,15] and real-world studies [16;17] - have found that the use of DET and GLAR in T2D patients results in comparable HbA1c improvements and a similar low risk of hypoglycaemia versus NPH, whereas DET is associated with significantly less weight gain than GLAR [12,13,14,15,16,17,18]. Recent real-world studies indicate dose similarities between DET and GLAR [19,20,21]
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