Insulin glargine 300 units/mL for the treatment of individuals with type 2 diabetes in the real world: A review of the DELIVER programme.

Abstract

Evidence from randomized controlled trials (RCTs) has shown that second‐generation basal insulin (BI) analogues, insulin glargine 300 U/mL (Gla‐300) and insulin degludec (IDeg), provide similar glycaemic control, with a lower risk of hypoglycaemia compared with the first‐generation BI analogue insulin glargine 100 U/mL (Gla‐100) in people with type 2 diabetes (T2D). However, the highly selected participants and frequent follow‐up of RCTs may not be truly representative of real‐life clinical practice. It is important to assess the safety and effectiveness of these second‐generation BI analogues in real‐life clinical practice settings. The DELIVER programme utilized electronic healthcare records from the United States to compare clinical outcomes in people with T2D who received either Gla‐300 or other BI analogues in real‐world clinical practice. This review provides a concise overview of the results of the DELIVER studies. Overall, Gla‐300 provided similar antihyperglycaemic effectiveness and a lower risk of hypoglycaemia versus the first‐generation BI analogues Gla‐100 and insulin detemir in people with T2D who had switched BIs. In those who were insulin‐naïve, initiation with Gla‐300 versus Gla‐100 was associated with significantly better antihyperglycaemic effectiveness and similar or lower hypoglycaemic risk. Both glycaemic control and hypoglycaemia risk were also shown to be similar with Gla‐300 and IDeg, in people who had switched BIs and in those who were insulin‐naïve. In addition, the DELIVER 2 study reported that people with T2D who switched to Gla‐300 had reduced healthcare resource utilization, with an overall saving of US$1439 per person per year compared with those who switched to another BI analogue. Overall, the real‐world DELIVER programme showed that the glycaemic control with a low risk of hypoglycaemia observed with Gla‐300 in RCTs was also seen in standard clinical practice.