Systematic review and meta-analysis of randomized clinical trials comparing efficacy and safety outcomes of insulin glargine with NPH insulin, premixed insulin preparations or with insulin detemir in type 2 diabetes mellitus

Rys, P; Wojciechowski, Piotr; Rogoz-Sitek, Agnieszka; Niesyczynski, G; Lis, J; Syta, Albert; Małecki, Maciej T.

doi:10.1007/s00592-014-0698-4

Cited by 93 publications

(75 citation statements)

References 79 publications

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“…Patients who switched to Gla‐300 had experienced fewer hypoglycaemic events at baseline than those who switched to another basal insulin. The substantially higher use of NPH insulin in the other switcher group is a possible explanation for this difference, as NPH insulin is associated with a higher rate of hypoglycaemia than Gla‐100 . It is notable that in a small retrospective study, concern regarding hypoglycaemia was one of the main reasons cited for switching to Gla‐300, a result somewhat in contrast to our own data …”

Section: Discussioncontrasting

confidence: 95%

Hypoglycaemia and treatment patterns among insulin‐treated patients with type 2 diabetes who switched to insulin glargine 300 units/mL versus other basal insulin in a real‐world setting

Zhou

Nicholls

Xie

et al. 2019

Endocrino Diabet & Metabol

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Introduction Type 2 diabetes (T2D) is characterized by worsening pancreatic β‐cell function often requiring treatment escalation with oral antidiabetic drugs ( OAD s), glucagon‐like peptide‐1 and eventually insulin. Although there is much evidence available on the initiation of basal insulins, fewer studies have investigated the effects of switching from one basal insulin to another. This study aims to evaluate treatment persistence and hypoglycaemia in adult patients with T2D on prior basal insulin who were switched to insulin glargine 300 units/mL (Gla‐300) or other basal insulins in a real‐world setting. Materials and methods This study is a retrospective cohort analysis of patient‐level data extracted from the Optum ® Clinformatics ™ database between 1 October 2014 and 30 June 2016. Adult patients (≥18 years) with T2D who were being treated with basal insulin during the 6‐month baseline period, who switched to either Gla‐300 or other basal insulins, were followed up for ≥3 months after switching. Outcomes included treatment persistence, and incidence and number of hypoglycaemic events. Results Of the included patients, 1204 switched to Gla‐300 and 616 switched to other basal insulins. Adjusting for baseline confounders, patients who switched to Gla‐300 were 34% less likely to discontinue their basal insulin than patients who switched to other basal insulins (hazard ratio [ HR ] 0.66; 95% confidence interval [ CI ] 0.54‐0.81; P < 0.001). Patients who switched to Gla‐300 were less likely to experience hypoglycaemia at 3‐month follow‐up (odds ratio [ OR ] 0.56, 95% CI 0.32‐0.97; P = 0.039) and at 6‐month follow‐up ( OR 0.58, 95% CI 0.38‐0.87; P = 0.009) compared with patients who switched to other basal insulins. Conclusions Patients with T2D on prior basal insulin in a real‐world setting who switched to Gla‐300 were more persistent with their basal insulin and experienced less hypoglycaemia than patients who switched to other basal insulins.

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Section: Discussioncontrasting

confidence: 95%

Hypoglycaemia and treatment patterns among insulin‐treated patients with type 2 diabetes who switched to insulin glargine 300 units/mL versus other basal insulin in a real‐world setting

Zhou

Nicholls

Xie

et al. 2019

Endocrino Diabet & Metabol

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“…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 …”

Section: Discussionsupporting

confidence: 93%

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

Zhang

Zhu

et al. 2017

Diabetes Obesity Metabolism

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“…A recent metaanalysis evaluating the relative efficacy and safety of insulins in T2D also found benefits with regards to hypoglycemia for the long-acting insulins; in combination with OADs, insulin glargine had a similar risk of symptomatic or severe hypoglycemia to insulin detemir (risk ratio [RR] 0.99 and 1.10, respectively), while insulin glargine had a lower risk of these outcomes than NPH insulin (RR 0.89 and 0.77, respectively) 15 . There is less data available for analysis of hypoglycemic risk associated with different insulins from the "real-world" setting, and recent studies from the US are limited to comparisons between insulin glargine and insulin detemir.…”

Section: Introductionmentioning

confidence: 99%

Hypoglycemia in patients with type 2 diabetes newly initiated on basal insulin in the US in a community setting: impact on treatment discontinuation and hospitalization

Dalal

Kazemi

Ye³

2016

Current Medical Research and Opinion

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Objective: To evaluate the impact of 6 month hypoglycemia on treatment discontinuation and hospitalization of patients initiating basal insulin for type 2 diabetes (T2D) in real-world practice. Methods: This was a retrospective cohort study of patient-level data using electronic medical records (EMRs) in the Predictive Health Intelligence diabetes dataset. Data from adult patients with T2D initiating basal insulin glargine, insulin detemir, or Neutral Protamine Hagedorn insulin between January 2008 and March 2014 was analyzed. The date of first basal insulin prescription in an outpatient setting was the index date. A 12 month baseline prior to the index date was established; follow-up was 6-24 months from the index date. Patients were assigned to cohorts by experience of hypoglycemia (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] code or blood glucose test) in the first 6 months following the index date; with hypoglycemia and without hypoglycemia cohorts were compared for basal insulin treatment discontinuation and hospitalization. Results: Overall, 49,062 patients were included; 5159 (10.5%) experienced hypoglycemia in the 6 months following basal insulin initiation. In the first 12 months, 68.1% of patients in the with hypoglycemia cohort discontinued basal insulin versus 53.9% in the without hypoglycemia cohort (p < .0001); more patients in the with hypoglycemia cohort had at least one hospitalization in the first year of follow-up (50.1% vs. 14.6%; p < .0001). Conclusion: Patients with hypoglycemia soon after initiating basal insulin are at greater risk of discontinuation of their basal insulin therapy and hospitalization versus those who did not have hypoglycemic events within the first 6 months of basal insulin initiation. A limitation of this study is that it was a retrospective analysis of EMR data and the study may not be representative of all US patients with T2D on basal insulin and it cannot be assumed that every hypoglycemic event was recorded.ARTICLE HISTORY

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Systematic review and meta-analysis of randomized clinical trials comparing efficacy and safety outcomes of insulin glargine with NPH insulin, premixed insulin preparations or with insulin detemir in type 2 diabetes mellitus

Cited by 93 publications

References 79 publications

Hypoglycaemia and treatment patterns among insulin‐treated patients with type 2 diabetes who switched to insulin glargine 300 units/mL versus other basal insulin in a real‐world setting

Hypoglycaemia and treatment patterns among insulin‐treated patients with type 2 diabetes who switched to insulin glargine 300 units/mL versus other basal insulin in a real‐world setting

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

Hypoglycemia in patients with type 2 diabetes newly initiated on basal insulin in the US in a community setting: impact on treatment discontinuation and hospitalization

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