Insulin detemir versus insulin glargine for type 2 diabetes mellitus

Abstract

Our analyses suggest that there is no clinically relevant difference in efficacy or safety between insulin detemir and insulin glargine for targeting hyperglycaemia. However, to achieve the same glycaemic control insulin detemir was often injected twice-daily in a higher dose but with less weight gain, while insulin glargine was injected once-daily, with somewhat fewer injection site reactions.

Hypoglycaemia assessment tool (HAT) study: subanalysis of the Lebanese cohort

“…The UK Hypoglycaemia Study reported mild hypoglycaemia rates of 10.2 events/patient-year and severe hypoglycaemia rates of 0.7 events/patientyear in patients with T2DM using insulin for > 5 years (23). Systematic reviews considering hypoglycaemia prevalence in randomized controlled trials involving patients with T2DM (28)(29)(30)(31) reported that severe hypoglycaemia prevalence was < 1%, which is substantially lower than our findings. In the Veterans Affairs Diabetes Trial involving T2DM patients, rates of any symptomatic hypoglycaemic episode were 383-1333 per 100 patientyears, whereas rates of severe hypoglycaemia were 3-9 per 100 patient-years (5).…”

Hypoglycaemia assessment tool (HAT) study: subanalysis of the Lebanese cohort

“…The UK Hypoglycaemia Study reported mild hypoglycaemia rates of 10.2 events/patient-year and severe hypoglycaemia rates of 0.7 events/patientyear in patients with T2DM using insulin for > 5 years (23). Systematic reviews considering hypoglycaemia prevalence in randomized controlled trials involving patients with T2DM (28)(29)(30)(31) reported that severe hypoglycaemia prevalence was < 1%, which is substantially lower than our findings. In the Veterans Affairs Diabetes Trial involving T2DM patients, rates of any symptomatic hypoglycaemic episode were 383-1333 per 100 patientyears, whereas rates of severe hypoglycaemia were 3-9 per 100 patient-years (5).…”

Comparative effectiveness and safety of different basal insulins in a real‐world setting

“…Again, although the clinical relevance is debatable, adding glargine was associated with the lowest rate of overall hypoglycaemia and adding detemir was associated with the lowest weight gain in the ORBIT study. Similar results were observed in previous RCT studies …”

Assessing achievement and maintenance of glycemic control by patients initiating basal insulin

“…We found that of the identified basal insulin initiators, 20.3% had baseline HbA1c levels between 8-9% and 39.2% with HbA1c49%. The results confirm the previous findings of a tendency towards late initiation of insulin treatment among T2DM patients 5,11 . Using a large administrative claims database in the US, Borah et al found that only 12.5% of detemir users and 10.1% of glargine users had a baseline HbA1c57% 7 .…”

Hypoglycaemia assessment tool (HAT) study: subanalysis of the Lebanese cohort

“…The UK Hypoglycaemia Study reported mild hypoglycaemia rates of 10.2 events/patient-year and severe hypoglycaemia rates of 0.7 events/patientyear in patients with T2DM using insulin for > 5 years (23). Systematic reviews considering hypoglycaemia prevalence in randomized controlled trials involving patients with T2DM (28)(29)(30)(31) reported that severe hypoglycaemia prevalence was < 1%, which is substantially lower than our findings. In the Veterans Affairs Diabetes Trial involving T2DM patients, rates of any symptomatic hypoglycaemic episode were 383-1333 per 100 patientyears, whereas rates of severe hypoglycaemia were 3-9 per 100 patient-years (5).…”

Comparative effectiveness and safety of different basal insulins in a real‐world setting

“…Again, although the clinical relevance is debatable, adding glargine was associated with the lowest rate of overall hypoglycaemia and adding detemir was associated with the lowest weight gain in the ORBIT study. Similar results were observed in previous RCT studies …”

Assessing achievement and maintenance of glycemic control by patients initiating basal insulin

“…We found that of the identified basal insulin initiators, 20.3% had baseline HbA1c levels between 8-9% and 39.2% with HbA1c49%. The results confirm the previous findings of a tendency towards late initiation of insulin treatment among T2DM patients 5,11 . Using a large administrative claims database in the US, Borah et al found that only 12.5% of detemir users and 10.1% of glargine users had a baseline HbA1c57% 7 .…”

Hypoglycaemia assessment tool (HAT) study: subanalysis of the Lebanese cohort

“…The UK Hypoglycaemia Study reported mild hypoglycaemia rates of 10.2 events/patient-year and severe hypoglycaemia rates of 0.7 events/patientyear in patients with T2DM using insulin for > 5 years (23). Systematic reviews considering hypoglycaemia prevalence in randomized controlled trials involving patients with T2DM (28)(29)(30)(31) reported that severe hypoglycaemia prevalence was < 1%, which is substantially lower than our findings. In the Veterans Affairs Diabetes Trial involving T2DM patients, rates of any symptomatic hypoglycaemic episode were 383-1333 per 100 patientyears, whereas rates of severe hypoglycaemia were 3-9 per 100 patient-years (5).…”

Comparative effectiveness and safety of different basal insulins in a real‐world setting

“…Again, although the clinical relevance is debatable, adding glargine was associated with the lowest rate of overall hypoglycaemia and adding detemir was associated with the lowest weight gain in the ORBIT study. Similar results were observed in previous RCT studies …”

Assessing achievement and maintenance of glycemic control by patients initiating basal insulin

“…We found that of the identified basal insulin initiators, 20.3% had baseline HbA1c levels between 8-9% and 39.2% with HbA1c49%. The results confirm the previous findings of a tendency towards late initiation of insulin treatment among T2DM patients 5,11 . Using a large administrative claims database in the US, Borah et al found that only 12.5% of detemir users and 10.1% of glargine users had a baseline HbA1c57% 7 .…”