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Association of Patient Profile with Glycemic Control and Hypoglycemia with Insulin Glargine 300 U/mL in Type 2 Diabetes: A Post Hoc Patient-Level Meta-Analysis

AIMS: To examine the association of baseline patient characteristics with study outcomes in people with type 2 diabetes receiving insulin glargine 300 U/mL (Gla-300) versus glargine 100 U/mL (Gla-100), over a 6-month period. METHODS: A post hoc patient-level meta-analysis using data from three multi...

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Autores principales: Twigg, Stephen M., Escalada, Javier, Stella, Peter, Merino-Trigo, Ana, Lavalle-Gonzalez, Fernando J., Cariou, Bertrand, Meneghini, Luigi F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Healthcare 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6167273/
https://www.ncbi.nlm.nih.gov/pubmed/30203238
http://dx.doi.org/10.1007/s13300-018-0498-x
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author Twigg, Stephen M.
Escalada, Javier
Stella, Peter
Merino-Trigo, Ana
Lavalle-Gonzalez, Fernando J.
Cariou, Bertrand
Meneghini, Luigi F.
author_facet Twigg, Stephen M.
Escalada, Javier
Stella, Peter
Merino-Trigo, Ana
Lavalle-Gonzalez, Fernando J.
Cariou, Bertrand
Meneghini, Luigi F.
author_sort Twigg, Stephen M.
collection PubMed
description AIMS: To examine the association of baseline patient characteristics with study outcomes in people with type 2 diabetes receiving insulin glargine 300 U/mL (Gla-300) versus glargine 100 U/mL (Gla-100), over a 6-month period. METHODS: A post hoc patient-level meta-analysis using data from three multicenter, randomized, open-label, parallel-group, phase 3a studies of similar design, in people previously receiving either basal and prandial insulin, basal insulin + oral antihyperglycemic drugs, or no prior insulin (EDITION 1, 2 and 3, respectively). The endpoints, glycated hemoglobin (HbA(1c)), hypoglycemia, body weight change, and insulin dose were investigated by subgroups: age (< 65 and ≥ 65 years), body mass index (BMI; < 30 and ≥ 30 kg/m(2)), age at onset (< 40, 40–50, and > 50 years), and diabetes duration (< 10 and ≥ 10 years). RESULTS: Reduction in HbA(1c) was comparable between insulins, regardless of subgroup. The lower risk of ≥ 1 nocturnal (00:00–05:59 h) confirmed (≤ 3.9 mmol/L [≤ 70 mg/dL]) or severe hypoglycemic event with Gla-300 versus Gla-100 was also unaffected by participant characteristics. While heterogeneity of treatment effect between diabetes duration subgroups was seen for the risk of ≥ 1 confirmed (≤ 3.9 mmol/L [≤ 70 mg/dL]) or severe hypoglycemic event at any time (24 h), treatment effect consistently favored Gla-300; no evidence of heterogeneity was observed for the other subgroups. Annualized rates of confirmed (≤ 3.9 mmol/L [≤ 70 mg/dL]) or severe hypoglycemia and body weight change were not influenced by participant characteristics; a similar pattern was observed with insulin dose. CONCLUSIONS: Comparable glycemic control was observed with Gla-300 versus Gla-100, with less hypoglycemia, regardless of age, BMI, age at onset or diabetes duration. FUNDING: Sanofi. PLAIN LANGUAGE SUMMARY: Plain language summary available for this article. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s13300-018-0498-x) contains supplementary material, which is available to authorized users.
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spelling pubmed-61672732018-10-08 Association of Patient Profile with Glycemic Control and Hypoglycemia with Insulin Glargine 300 U/mL in Type 2 Diabetes: A Post Hoc Patient-Level Meta-Analysis Twigg, Stephen M. Escalada, Javier Stella, Peter Merino-Trigo, Ana Lavalle-Gonzalez, Fernando J. Cariou, Bertrand Meneghini, Luigi F. Diabetes Ther Original Research AIMS: To examine the association of baseline patient characteristics with study outcomes in people with type 2 diabetes receiving insulin glargine 300 U/mL (Gla-300) versus glargine 100 U/mL (Gla-100), over a 6-month period. METHODS: A post hoc patient-level meta-analysis using data from three multicenter, randomized, open-label, parallel-group, phase 3a studies of similar design, in people previously receiving either basal and prandial insulin, basal insulin + oral antihyperglycemic drugs, or no prior insulin (EDITION 1, 2 and 3, respectively). The endpoints, glycated hemoglobin (HbA(1c)), hypoglycemia, body weight change, and insulin dose were investigated by subgroups: age (< 65 and ≥ 65 years), body mass index (BMI; < 30 and ≥ 30 kg/m(2)), age at onset (< 40, 40–50, and > 50 years), and diabetes duration (< 10 and ≥ 10 years). RESULTS: Reduction in HbA(1c) was comparable between insulins, regardless of subgroup. The lower risk of ≥ 1 nocturnal (00:00–05:59 h) confirmed (≤ 3.9 mmol/L [≤ 70 mg/dL]) or severe hypoglycemic event with Gla-300 versus Gla-100 was also unaffected by participant characteristics. While heterogeneity of treatment effect between diabetes duration subgroups was seen for the risk of ≥ 1 confirmed (≤ 3.9 mmol/L [≤ 70 mg/dL]) or severe hypoglycemic event at any time (24 h), treatment effect consistently favored Gla-300; no evidence of heterogeneity was observed for the other subgroups. Annualized rates of confirmed (≤ 3.9 mmol/L [≤ 70 mg/dL]) or severe hypoglycemia and body weight change were not influenced by participant characteristics; a similar pattern was observed with insulin dose. CONCLUSIONS: Comparable glycemic control was observed with Gla-300 versus Gla-100, with less hypoglycemia, regardless of age, BMI, age at onset or diabetes duration. FUNDING: Sanofi. PLAIN LANGUAGE SUMMARY: Plain language summary available for this article. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s13300-018-0498-x) contains supplementary material, which is available to authorized users. Springer Healthcare 2018-09-10 2018-10 /pmc/articles/PMC6167273/ /pubmed/30203238 http://dx.doi.org/10.1007/s13300-018-0498-x Text en © The Author(s) 2018 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Research
Twigg, Stephen M.
Escalada, Javier
Stella, Peter
Merino-Trigo, Ana
Lavalle-Gonzalez, Fernando J.
Cariou, Bertrand
Meneghini, Luigi F.
Association of Patient Profile with Glycemic Control and Hypoglycemia with Insulin Glargine 300 U/mL in Type 2 Diabetes: A Post Hoc Patient-Level Meta-Analysis
title Association of Patient Profile with Glycemic Control and Hypoglycemia with Insulin Glargine 300 U/mL in Type 2 Diabetes: A Post Hoc Patient-Level Meta-Analysis
title_full Association of Patient Profile with Glycemic Control and Hypoglycemia with Insulin Glargine 300 U/mL in Type 2 Diabetes: A Post Hoc Patient-Level Meta-Analysis
title_fullStr Association of Patient Profile with Glycemic Control and Hypoglycemia with Insulin Glargine 300 U/mL in Type 2 Diabetes: A Post Hoc Patient-Level Meta-Analysis
title_full_unstemmed Association of Patient Profile with Glycemic Control and Hypoglycemia with Insulin Glargine 300 U/mL in Type 2 Diabetes: A Post Hoc Patient-Level Meta-Analysis
title_short Association of Patient Profile with Glycemic Control and Hypoglycemia with Insulin Glargine 300 U/mL in Type 2 Diabetes: A Post Hoc Patient-Level Meta-Analysis
title_sort association of patient profile with glycemic control and hypoglycemia with insulin glargine 300 u/ml in type 2 diabetes: a post hoc patient-level meta-analysis
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6167273/
https://www.ncbi.nlm.nih.gov/pubmed/30203238
http://dx.doi.org/10.1007/s13300-018-0498-x
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