Insulin glargine-based therapy improves glycemic control in patients with type 2 diabetes sub-optimally controlled on premixed insulin therapies

Davies, Melanie J.; Sinnassamy, P; Storms, F.; Gomis, Ramón

doi:10.1016/j.diabres.2007.09.013

Cited by 38 publications

(24 citation statements)

References 21 publications

(2 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous studies have found that, when compared with basal insulin alone, premixed insulin formulations lower A 1c levels to a greater extent but at the same time result in slightly more hypoglycemic events9,26,27 and more weight gain 9,26–28. Similarly, others have reported fewer hypoglycemic events with GLA in a basal-bolus regimen than with PMX 16,29–31. In this study, there were no statistically significant differences in the rates of hypoglycemia between the GLA and PMX cohorts.…”

Section: Discussionmentioning

confidence: 92%

Real-world outcomes of initiating insulin glargine-based treatment versus premixed analog insulins among US patients with type 2 diabetes failing oral antidiabetic drugs

Başer¹,

Tangirala²,

Wei³

et al. 2013

CEOR

View full text Add to dashboard Cite

BackgroundIn patients with type 2 diabetes mellitus, basal-bolus strategies can improve treatment by offering dosing flexibility, and improved satisfaction, adherence, and clinical outcomes. The purpose of this study was to compare real-world outcomes between US patients initiating analog insulin therapy with insulin glargine and those initiating with a premixed analog insulin (PMX).MethodsThis was a retrospective study of data from patients (≥18 years) with type 2 diabetes mellitus in the IMPACT® database who initiated insulin treatment with insulin glargine (GLA) or a PMX. Clinical and economic outcomes were measured over one year, including persistence and adherence, consumption of insulin, glycemic outcomes, incident hypoglycemia, and health care resource utilization and cost.ResultsData from 2,502 patients were included in the analyses (n = 834 for PMX, n = 1,668 for GLA). Compared with PMX, persistence was higher and consumption of insulin was lower for GLA (both P < 0.0001). Adherence, glycemic outcomes, and hypoglycemia-related events were similar between groups, as were health care utilization and total health care costs. Diabetes-related drug and supply costs were lower for GLA than for PMX (P < 0.0001 and P = 0.046, respectively).ConclusionIn US patients with type 2 diabetes mellitus, initiating insulin with once-daily GLA, rather than a PMX, is associated with increased treatment persistence and similar clinical and hypoglycemic outcomes, but lower diabetes pharmacy and supply costs. GLA may be a more flexible option than PMX. However, these results also show suboptimal glycemic control in the real-world setting despite change in treatment regimens and call for optimization in management of patients with type 2 diabetes mellitus.

show abstract

Section: Discussionmentioning

confidence: 92%

Real-world outcomes of initiating insulin glargine-based treatment versus premixed analog insulins among US patients with type 2 diabetes failing oral antidiabetic drugs

Başer¹,

Tangirala²,

Wei³

et al. 2013

CEOR

View full text Add to dashboard Cite

show abstract

“…There was no significant difference in the incidence of severe hypoglycemia between the physician-led versus the self-managed group (0.9% vs 1.1%, respectively). A follow-up of that study revealed that the incidence of severe hypoglycemia decreased over time 11 . Simple, easy-to-follow patient-driven algorithms empower the patient, improve medication adherence and provide good glycemic control.…”

Section: Importance Of Patient Education Patient-centered Care and Cmentioning

confidence: 98%

Patient empowerment and optimal glycemic control

White

2012

Current Medical Research and Opinion

View full text Add to dashboard Cite

Patients with T2DM who are empowered with knowledge about their disease and treatment can take an active role in their diabetes care, and therefore, are more likely to achieve blood glucose and A1C goals, which can slow progression of their disease and the onset of complications. Although concentrating solely on medical information and physiological facts does not guarantee patient empowerment and self-management, educational strategies such as interactive teaching, problem solving and individualized education can have a positive impact. Insulin titration algorithms can empower patients to manage their therapy, and such algorithms are simple to use for patients treated with insulin analogs. As patients with T2DM become empowered by knowledge and gain more control of their disease, their physicians must then serve as their advisors rather than as their directors or prescribers.

show abstract

“…When the addition of basal insulin to oral agents is insufficient to achieve adequate glycemic control, injections of prandial insulin are often added (6). The addition of prandial insulin to basal insulin has been shown to further reduce HbA 1c levels compared with basal insulin alone (7,8). However, this approach is generally limited by hypoglycemia and weight gain (9,10).…”

mentioning

confidence: 99%

Advancing Basal Insulin Replacement in Type 2 Diabetes Inadequately Controlled With Insulin Glargine Plus Oral Agents: A Comparison of Adding Albiglutide, a Weekly GLP-1 Receptor Agonist, Versus Thrice-Daily Prandial Insulin Lispro

et al. 2014

View full text Add to dashboard Cite

OBJECTIVEGLP-1 receptor agonists may provide an alternative to prandial insulin for advancing basal insulin therapy. Harmony 6 was a randomized, open-label, activecontrolled trial testing once-weekly albiglutide vs. thrice-daily prandial insulin lispro as an add-on to titrated once-daily insulin glargine. RESEARCH DESIGN AND METHODSPatients taking basal insulin (with or without oral agents) with HbA 1c 7-10.5% (53-91 mmol/mol) entered a glargine standardization period, followed by randomization to albiglutide, 30 mg weekly (n = 282), subsequently uptitrated to 50 mg, if necessary, or thrice-daily prandial lispro (n = 281) while continuing metformin and/or pioglitazone. Glargine was titrated to fasting plasma glucose of <5.6 mmol/L, and lispro was adjusted based on glucose monitoring. The primary end point was the difference in the HbA 1c change from baseline at week 26. RESULTSAt week 26, HbA 1c decreased from baseline by 20.82 6 SE 0.06% (9.0 mmol/mol) with albiglutide and 20.66 6 0.06% (7.2 mmol/mol) with lispro; treatment difference, 20.16% (95% CI 20.32 to 0.00; 1.8 mmol/mol; P < 0.0001), meeting the noninferiority end point (margin, 0.4%). Weight decreased with albiglutide but increased with lispro (20.73 6 0.19 kg vs. +0.81 6 0.19 kg). The mean glargine dose increased from 47 to 53 IU (albiglutide) and from 44 to 51 IU (lispro). Adverse events for albiglutide versus lispro included severe hypoglycemia (0 vs. 2 events), documented symptomatic hypoglycemia (15.8% vs. 29.9%), nausea (11.2% vs. 1.4%), vomiting (6.7% vs. 1.4%), and injection site reactions (9.5% vs. 5.3%). CONCLUSIONSWeekly albiglutide is a simpler therapeutic option than thrice-daily lispro for advancing basal insulin glargine therapy, resulting in comparable HbA 1c reduction with weight loss and lower hypoglycemia risk.

show abstract

Insulin glargine-based therapy improves glycemic control in patients with type 2 diabetes sub-optimally controlled on premixed insulin therapies

Cited by 38 publications

References 21 publications

Real-world outcomes of initiating insulin glargine-based treatment versus premixed analog insulins among US patients with type 2 diabetes failing oral antidiabetic drugs

Real-world outcomes of initiating insulin glargine-based treatment versus premixed analog insulins among US patients with type 2 diabetes failing oral antidiabetic drugs

Patient empowerment and optimal glycemic control

Advancing Basal Insulin Replacement in Type 2 Diabetes Inadequately Controlled With Insulin Glargine Plus Oral Agents: A Comparison of Adding Albiglutide, a Weekly GLP-1 Receptor Agonist, Versus Thrice-Daily Prandial Insulin Lispro

Contact Info

Product

Resources

About