Hypoglycaemia risk in T2D: comparison of insulin degludec and insulin glargine

  • Philis-Tsimikas A & al.
  • Diabetologia
  • 27 Jan 2020

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • In patients with type 2 diabetes (T2D), no significant difference was observed in the rate of overall symptomatic hypoglycaemia between insulin degludec U200 and insulin glargine U300 during the maintenance period.
  • The rate of nocturnal symptomatic and severe hypoglycaemia was lower with insulin degludec U200 vs insulin glargine U300.

Why this matters

  • Findings add to the existing evidence on the latest basal insulins, degludec U200 and glargine U300, which may help health care providers and health systems in achieving blood glucose targets for patients more safely.

Study design

  • CONCLUDE trial of 1609 patients with T2D who were randomly assigned to receive insulin degludec U200 (n=805) and insulin glargine U300 (n=804).
  • Primary endpoint: overall symptomatic hypoglycaemic events during the maintenance period.
  • Secondary outcomes: nocturnal symptomatic and severe hypoglycaemic events during the maintenance period.
  • Funding: Novo Nordisk.

Key results

  • During the maintenance period:
    • No significant difference was observed in the rate of symptomatic hypoglycaemia events between insulin degludec U200 and glargine U300 (rate ratio [RR], 0.88; 95% CI, 0.73-1.06).
    • The rate of nocturnal symptomatic (RR, 0.63; 95% CI, 0.48-0.84) and severe (RR, 0.20; 95% CI, 0.07-0.57) hypoglycaemic events was lower with insulin degludec U200 vs glargine U300.
  • Total treatment period:
    • Insulin degludec U200 vs glargine U300 was associated with a reduction in the rate of symptomatic hypoglycaemia events (RR, 0.77; 95% CI, 0.65-0.92).
    • Insulin degludec U200 vs glargine U300 had lower rate of nocturnal symptomatic (RR, 0.57; 95% CI, 0.44-0.74) and severe (RR, 0.38; 95% CI, 0.21-0.70) hypoglycaemic events.

Limitations

  • Risk of unknown confounding.