Switching to insulin glargine 300 IU/mL vs 100 IU/mL in older T2D patients

  • Bailey TS & al.
  • Diabetes Obes Metab
  • 2 Jul 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.


  • In older patients with type 2 diabetes (T2D), switching to insulin glargine 300 units/mL (Gla-300) was associated with greater or similar improvements in glycaemic control and less hypoglycaemia incidence, event rates and healthcare resource utilisation compared with switching to insulin glargine 100 units/mL (Gla-100 units/mL) or insulin detemirs (IDet).

Why this matters

  • Older age group is important because they account for ~40% of patients with T2D are at an increased risk of hypoglycaemia and its sequelae and are underrepresented in clinical trials.

Study design

  • DELIVER 3 study of electronic medical records included 1176 older patients (age, ≥ 65 years) with T2D who switched from basal insulin to Gla-300 and 1176 propensity score-matched patients who switched to IDet or Gla-100.
  • Main outcomes: follow-up (variable and fixed) haemoglobin A1c (HbA1c), HbA1c goal achievement (
  • Funding: Sanofi.

Key results

  • Following basal insulin switching, Gla-300 vs IDet/Gla-100 group had greater/similar reduction in HbA1c by variable (−0.45%±1.40% vs −0.29%±1.57%; P=.021) and fixed (−0.48%±1.49% vs −0.38%±1.59%; P=.114) follow-up, respectively.
  • No difference was observed in HbA1c goal achievement between Gla-300 and IDet/Gla-100 group.
  • By variable follow-up, Gla-300 vs IDet/Gla-100 group was associated with lower risk for:
    • hypoglycaemia (adjusted rate ratio [aRR], 0.63; 95% CI, 0.53-0.75; P<.001 and>
    • inpatient- (adjusted HR, 0.58; 95% CI, 0.37-0.90; P=.016) and emergency department-associated hypoglycaemia (aRR, 0.43; 95% CI, 0.31-0.60; P<.001>
  • Hypoglycaemia-related inpatient incidence (adjusted OR, 0.38; 95% CI, 0.18-0.83; P=.015) and event rates (aRR, 0.27; 95% CI, 0.12-0.58; P<.001 and inpatient days ci p were significantly lower in gla-300 vs idet group.>


  • Retrospective design and short follow-up.
  • Risk for selection bias.