Switching to Insulin Glargine U300 Beneficial in Poorly Controlled Diabetes
This article is written live from the American Association of Clinical Endocrinologists (AACE) 2017 Annual Meeting in Austin, TX. MPR will be reporting news on the latest findings from leading experts in endocrinology. Check back for more news from AACE 2017.
Researchers from the Water Reed National Military Medical Center concluded that healthcare professionals should consider switching patients with uncontrolled HbA1c on basal U100 or multi-dose insulin regimen to a longer acting basal insulin such as glargine U300. Findings from the retrospective review were presented at the AACE 2017 Annual Meeting.
Insulin detemir or Insulin glargine U100 serve as common basal insulins for patients with uncontrolled diabetes mellitus. Additional basal insulins are now available and may improve glycemic control in patients vs. these standard basal insulin regimens. For example, insulin glargine U300 is a long-acting basal insulin reported to have more consistent basal coverage and lower glycemic variability vs. standard insulin analogues.
"Our institution began to utilize glargine U300 in an attempt to optimize glycemic control in patients that are poorly controlled with standard basal regimens," explained lead author Huong Trinh Nguyen, NP. Clinical data for one patient with type 1 diabetes and four patients with type 2 diabetes who were being treated with basal glargine U100 or detemir were analyzed. These patients were then switched to glargine U300 per drug labeling without any initial adjustment in pre-existing pre-prandial insulin or antihyperglycemic drugs. Study authors reviewed the patients' HbA1c, weight, and BMI at baseline and at 3 months.
In the patient with type 1 diabetes, the change in HbA1c was 0.7% whereas the HbA1c change for the patients with type 2 diabetes ranged from 1.6–3% at 3 months. "The patients' BMI and weight was overall unchanged at 3 months in both groups," Dr. Trinh explained.
One of the type 2 diabetes patients had a reduction in pre-prandial insulin requirements by 41% and another patient no longer required pre-prandial insulin. The type 1 diabetes patient was able to reduce prandial insulin requirement by 30%. Moreover, two of the patients who experienced hypoglycemic episodes before receiving insulin glargine U300 had resolution of hypoglycemia. Overall, all of the study patients reported "improved well-being and compliance" with the use of insulin glargine U300.
Study patients showed reduced HbA1c and pre-prandial insulin requirements after transitioning to insulin glargine U300. "These real world results show that glargine U300 improves glycemic control with a possible reduction in hypoglycemic events," concluded Dr. Trinh.
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