21
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      A post‐hoc pooled analysis to evaluate the risk of hypoglycaemia with insulin glargine 300 U/mL (Gla‐300) versus 100 U/mL (Gla‐100) over wider nocturnal windows in individuals with type 2 diabetes on a basal‐only insulin regimen

      brief-report

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          The EDITION trials in type 2 diabetes demonstrated comparable glycaemic control with less nocturnal and anytime (24‐hour) hypoglycaemia for insulin glargine 300 U/mL (Gla‐300) versus glargine 100 U/mL (Gla‐100). However, the predefined nocturnal window (0:00–5:59 am) may not be the most relevant for clinical practice. This post‐hoc analysis compared expansions of the predefined nocturnal interval during basal insulin treatment without prandial insulin. Patient‐level, 6‐month data, pooled from the EDITION 2 and 3 trials and the EDITION JP 2 trial ( N = 1922, basal insulin only) were analysed. Accompanying hypoglycaemia during treatment with Gla‐300 was compared to that during treatment with Gla‐100, using predefined (0:00–5:59 am) and expanded (10:00 pm–5:59 am, 0:00–7:59 am, 10:00 pm to pre‐breakfast SMPG) windows. Confirmed (≤3.9 mmol/L [≤70 mg/dL]) or severe hypoglycaemic events were reported most frequently between 6:00 am and 8:00 am. Windows expanded beyond 6:00 am included more events than other windows. The percentage of participants with at least one event was lower with Gla‐300 than Gla‐100 in all windows examined. Expanding the nocturnal interval allows better assessment of the risk of hypoglycaemia associated with basal insulin. The risk of nocturnal hypoglycaemia was consistently lower with Gla‐300 versus Gla‐100 using all four windows.

          Related collections

          Most cited references7

          • Record: found
          • Abstract: found
          • Article: found
          Is Open Access

          Insulin adherence behaviours and barriers in the multinational Global Attitudes of Patients and Physicians in Insulin Therapy study

          Aims To examine patient and physician beliefs regarding insulin therapy and the degree to which patients adhere to their insulin regimens. Methods Internet survey of 1250 physicians (600 specialists, 650 primary care physicians) who treat patients with diabetes and telephone survey of 1530 insulin-treated patients (180 with Type 1 diabetes, 1350 with Type 2 diabetes) in China, France, Japan, Germany, Spain, Turkey, the UK or the USA. Results One third (33.2%) of patients reported insulin omission/non-adherence at least 1 day in the last month, with an average of 3.3 days. Three quarters (72.5%) of physicians report that their typical patient does not take their insulin as prescribed, with a mean of 4.3 days per month of basal insulin omission/non-adherence and 5.7 days per month of prandial insulin omission/non-adherence. Patients and providers indicated the same five most common reasons for insulin omission/non-adherence: too busy; travelling; skipped meals; stress/emotional problems; public embarrassment. Physicians reported low patient success at initiating insulin in a timely fashion and adjusting insulin doses. Most physicians report that many insulin-treated patients do not have adequate glucose control (87.6%) and that they would treat more aggressively if not for concern about hypoglycaemia (75.5%). Although a majority of patients (and physicians) regard insulin treatment as restrictive, more patients see insulin treatment as having positive than negative impacts on their lives. Conclusions Glucose control is inadequate among insulin-treated patients, in part attributable to insulin omission/non-adherence and lack of dose adjustment. There is a need for insulin regimens that are less restrictive and burdensome with lower risk of hypoglycaemia.
            Bookmark
            • Record: found
            • Abstract: not found
            • Article: not found

            Introduction.

              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              The past, present, and future of basal insulins.

              Insulin production by the pancreas follows a basic pattern where basal levels of insulin are secreted during fasting periods, with prandial increases in insulin associated with food ingestion. The aim of insulin therapy in patients with diabetes is to match the endogenous pattern of insulin secretion as closely as possible without causing hypoglycaemia. There are several optimal pharmacokinetic and pharmacodynamic properties of long-acting basal insulins that can help to achieve this aim, namely, as follows: activity that is flat and as free of peaks as possible, a duration of action of ≥24-h, and as little day-to-day variation as possible. The long-acting basal insulins are a fundamental therapy for patients with type 1 and type 2 diabetes, and those that are currently available have many benefits; however, the development of even longer-acting insulins and improved insulin delivery techniques may lead to better glycemic control for patients in the future. Established long-acting basal insulins available in the United States and Europe include insulin glargine 100 units/mL and insulin detemir, both of which exhibit similar glycemic control to that of the intermediate-acting neutral protamine Hagedorn insulin, but with a reduction in hypoglycaemia. Newer insulin products available include new insulin glargine 300 units/mL (United States and Europe) and the ultra-long-acting insulin degludec (Europe) with basal insulin peglispro currently in development. These new insulins demonstrate different pharmacokinetic/pharmacodynamic profiles and longer durations of action (>24 h) compared with insulin glargine 100 units/mL, which may lead to potential benefits. The introduction of biosimilar insulins may also broaden access to insulins by reducing treatment costs. Copyright © 2015 John Wiley & Sons, Ltd.
                Bookmark

                Author and article information

                Contributors
                geremia.bolli@unipg.it
                Journal
                Diabetes Obes Metab
                Diabetes Obes Metab
                10.1111/(ISSN)1463-1326
                DOM
                Diabetes, Obesity & Metabolism
                Blackwell Publishing Ltd (Oxford, UK )
                1462-8902
                1463-1326
                02 October 2018
                February 2019
                : 21
                : 2 ( doiID: 10.1111/dom.2019.21.issue-2 )
                : 402-407
                Affiliations
                [ 1 ] Department of Medicine University of Perugia Perugia Italy
                [ 2 ] Diabetes and Endocrinology Center Rockwood Clinic Spokane Washington
                [ 3 ] Glasgow Royal Infirmary University of Glasgow Glasgow UK
                [ 4 ] Sanofi Paris France
                [ 5 ] Oregon Health and Science University Portland Oregon
                Author notes
                [*] [* ] Correspondence

                Geremia B. Bolli, MD, Section of Endocrinology and Metabolism, Department of Medicine, Hospital S.M. della Misericordia, Piazzale Gambuli, 1, 06129 Perugia PG, Italy.

                Email: geremia.bolli@ 123456unipg.it

                Author information
                https://orcid.org/0000-0003-4966-4003
                https://orcid.org/0000-0003-1169-3036
                Article
                DOM13515
                10.1111/dom.13515
                6586031
                30160030
                a6fa837c-d420-4002-b016-425dde701d59
                © 2018 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 06 June 2018
                : 24 August 2018
                : 26 August 2018
                Page count
                Figures: 1, Tables: 1, Pages: 6, Words: 4364
                Funding
                Funded by: Sanofi
                Award ID: NCT01499095
                Award ID: NCT01676220
                Award ID: NCT01689142
                Categories
                Brief Report
                Brief Reports
                Custom metadata
                2.0
                dom13515
                February 2019
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.6.4 mode:remove_FC converted:20.06.2019

                Endocrinology & Diabetes
                basal insulin,hypoglycaemia,type 2 diabetes
                Endocrinology & Diabetes
                basal insulin, hypoglycaemia, type 2 diabetes

                Comments

                Comment on this article

                scite_

                Similar content191

                Cited by4

                Most referenced authors300