Glargine-300 bests glargine-100 in T1D and T2D

  • Díez-Fernández A & al.
  • Acta Diabetol
  • 3 Dec 2018

  • curated by Miriam Tucker
  • Clinical Essentials
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Takeaway

  • Glargine-300 reduces nocturnal hypoglycemia and slightly improves glycemic control compared with glargine-100 in adults with type 1 diabetes (T1D) or type 2 diabetes (T2D).

Why this matters

  • Basal insulins have significantly improved treatment of both T1D and T2D, but hypoglycemia remains a barrier to optimal glycemic control.  

Study design

  • Systematic review and meta-analysis of 9 studies comparing glargine-300 with glargine-100 in 3977 adults with T1D or T2D.
  • Funding: None.

Key results

  • Glargine-300 was significantly associated with less confirmed nocturnal hypoglycemia (pooled relative risk [RR], 0.81; 95% CI, 0.69-0.95) and clinically significant nocturnal hypoglycemia (RR, 0.75; 95% CI, 0.63-0.91).
  • In subgroup analysis by diabetes type, glargine-300 was associated with less confirmed nocturnal hypoglycemia in T1D (RR, 0.64; 95% CI, 0.42-0.97).
  • There was a decrease in HbA1c in favor of glargine-300 (effect size, −0.08; 95% CI, −0.14 to −0.01).

Limitations

  • Relative short duration of studies.
  • Differences in injector devices across studies.
  • Missing data on weight gain, increased insulin dose, or adverse events in some studies.
  • Between-study heterogeneity in T1D studies regarding nocturnal hypoglycemia.

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