Continuous Insulin Glargine vs. Detemir Impact on A1C Levels
Sanofi announced the results of a real world outcome study on insulin glargine (Lantus) injection vs. insulin detemir (Levemir; Novo Nordisk) injection on A1C levels. The research was presented at the 2014 American Diabetes Association Scientific Sessions.
The retrospective study of 13,942 adults with type 2 diabetes evaluated the patients between 2006–2012 for hemoglobin A1C (A1C) and weight measures at baseline. Patients were split between two groups; Cohort 1 was switched to insulin detemir from insulin glargine or continued on insulin glargine and Cohort 2 was switched from insulin glargine from insulin detemir or continued on insulin detemir.
After 1 year, patients in Cohort 1 that switched to insulin detemir had lower treatment adherence vs. those who continued on insulin glargine (52.5% vs. 61.4%; P<0.0001), as well as a significantly less reduction in A1C (-0.24% vs. -0.46%, P<0.0001). A significantly lower portion of the patients taking insulin detemir achieved A1C <7% (21.0% vs. 26.1%, P<0.0001) and A1C <8% (45.7% vs. 53.2%, P<0.0001). No significant differences were seen in rates of hypoglycemia or weight gain between the groups in Cohort 1.
In Cohort 2, patients that switched to insulin glargine had a significantly lower A1C (8.1% vs. 8.3%, P=0.0213) but the proportion of patients achieving A1C <7% and AIC were similar between the groups in Cohort 2. Rates of hypoglycemia were similar between the groups but patients that switched to insulin glargine had significantly greater weight gain compared to those who remained on insulin detemir (3.2lbs vs. 0.07lbs, P<0.001).
Both insulin glargine and insulin detemir are indicated for the treatment of type 1 diabetes (in adults and children) and type 2 diabetes (in adults) when basal (long-acting) insulin is needed.
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