Self-Titration with Insulin Glargine 300 or 100 U/mL has Improved Efficacy vs. Physician-Led Titration—Comparison of the TAKE-CONTROL, AT.LANTUS, and ATLAS Studies in People with Type 2 Diabetes (T2DM)

Abstract

Empowering individuals to self-titrate their basal insulin may help to reduce rates of sub-optimal titration often observed in clinical practice and help more people achieve HbA1c goals. Here we compare the results from the recently completed TAKE CONTROL study, which evaluated self-titration and physician-led titration of insulin glargine 300 U/mL (Gla-300) in people with T2DM, with comparable studies (AT.LANTUS and ATLAS) of insulin glargine 100 U/mL (Gla-100). All 3 studies were 24-week, multicenter, randomized, open-label, parallel-group studies. Fasting blood glucose targets were 80-130 mg/dL (4.4-7.2 mmol/L) in TAKE CONTROL, ≤100 mg/dL (5.5 mmol/L) in AT.LANTUS and ≤110 mg/dL (6.1 mmol/L) in ATLAS. Mean baseline HbA1c was between 8.4 and 8.9% (Table). Self-titration statistically significantly lowered mean HbA1c by 0.97 to 1.40% vs. physician-led titration (0.84 to 1.25%; p<0.for all 3 studies). The incidence of severe hypoglycemia and other safety outcomes was similar between titration arms in all 3 studies (Table). Both Gla-300 and Gla-100 were effective in improving glycemic control. Self-titration with Gla-300 resulted in significantly improved glycemic control vs. physician-led titration, as demonstrated previously with Gla-100, without increased hypoglycemia. Disclosure M. Davies: Advisory Panel; Self; AstraZeneca. Board Member; Self; AstraZeneca. Consultant; Self; AstraZeneca. Speaker's Bureau; Self; AstraZeneca. Advisory Panel; Self; Boehringer Ingelheim Pharmaceuticals, Inc.. Board Member; Self; Boehringer Ingelheim Pharmaceuticals, Inc.. Consultant; Self; Boehringer Ingelheim Pharmaceuticals, Inc.. Speaker's Bureau; Self; Boehringer Ingelheim Pharmaceuticals, Inc.. Advisory Panel; Self; Eli Lilly and Company. Board Member; Self; Eli Lilly and Company. Consultant; Self; Eli Lilly and Company. Speaker's Bureau; Self; Eli Lilly and Company. Advisory Panel; Self; Janssen Pharmaceuticals, Inc.. Board Member; Self; Janssen Pharmaceuticals, Inc.. Consultant; Self; Janssen Pharmaceuticals, Inc.. Speaker's Bureau; Self; Janssen Pharmaceuticals, Inc.. Advisory Panel; Self; Novo Nordisk Inc.. Board Member; Self; Novo Nordisk Inc.. Consultant; Self; Novo Nordisk Inc.. Research Support; Self; Novo Nordisk Inc.. Speaker's Bureau; Self; Novo Nordisk Inc.. Board Member; Self; Sanofi-Aventis. Consultant; Self; Sanofi-Aventis. Research Support; Self; Sanofi-Aventis. Advisory Panel; Self; Sanofi-Aventis. Speaker's Bureau; Self; Sanofi-Aventis. Advisory Panel; Self; Servier. Consultant; Self; Intarcia Therapeutics, Inc.. Speaker's Bureau; Self; Mitsubishi Tanabe Pharma Corporation. E. Boelle-Le Corfec: Employee; Self; Sanofi. Stock/Shareholder; Self; Sanofi. M. Bonnemaire: Employee; Self; Sanofi. Stock/Shareholder; Self; Sanofi. M. Odawara: Speaker's Bureau; Self; Sanofi, Novo Nordisk Inc.. Research Support; Self; Novo Nordisk Inc., Sanofi. Speaker's Bureau; Self; Eli Lilly and Company. Research Support; Self; Eli Lilly and Company. Advisory Panel; Self; Sanofi, Novo Nordisk Inc., Eli Lilly and Company. L. Popescu: Employee; Self; Sanofi. Stock/Shareholder; Self; Sanofi. J. Sieber: Employee; Self; Sanofi. Stock/Shareholder; Self; Sanofi. D. Russell-Jones: Other Relationship; Self; AstraZeneca, Boehringer Ingelheim, Cellnovo, Eli Lilly and Company, Novartis, Novo Nordisk, Sanofi. K. Strojek: Research Support; Self; AstraZeneca. Other Relationship; Self; Sanofi-Aventis, Novo Nordisk A/S. Speaker's Bureau; Self; Servier, Eli Lilly and Company, MSD K.K., Boehringer Ingelheim GmbH. Research Support; Self; Pfizer Inc., Amgen Inc.. Speaker's Bureau; Self; Janssen Pharmaceuticals, Inc. N. Tentolouris: Advisory Panel; Self; MSD K.K., AstraZeneca, Sanofi, Novo Nordisk A/S, Elpen Pharmaceutical Co. Inc., Eli Lilly and Company, Boehringer Ingelheim GmbH, Novartis AG. Research Support; Self; MSD K.K., Eli Lilly and Company, Novo Nordisk A/S, Sanofi, Pfizer Inc., AstraZeneca, Janssen-Cilag Pty Limited, GlaxoSmithKline plc., Novartis AG.