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

ABSTRACTAims: 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 (HbA1c) 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, HbA1c 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. HbA1c 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.