Therapy Optimization with Once Daily Glargine Gla-300–Based Therapy in Patients Insufficiently Controlled on Premixed Insulins or Twice Daily Basal Regimens—Real-Life Data

Abstract

Introduction: In Slovenia, as in many Central Europe countries, there is a high share of patients with T2D treated with human basal and premixed insulins. Many of them are often sub optimally controlled. One barrier to the achievement of optimal glycaemic control is the risk of hypoglycaemia, a common side effect of insulin therapy. Gla-300 is a new formulation of insulin glargine delivering the same amount of insulin as insulin glargine 100 units/mL (Gla-100) in a 1/3 volume. Pharmacokinetic and pharmacodynamic action profiles of Gla-300 are more constant and prolonged compared with Gla-100, due to a more gradual and extended release of glargine from the subcutaneous depot which allows continued blood glucose control beyond 24 hours.

Study Design: We performed a retrospective, observational study. We have obtained data from medical charts of T2D and T1D patients, who initiated Gla-300 in the period from May 1^st, 2016 to June 1^st, 2017. The primary objective was to evaluate a real-life efficacy of once daily Gla-300 basal insulin therapy in patients insufficiently controlled on premixed insulins or twice- daily basal regimens, defined as the mean change in HbA1c value 3 or 6 months after the switch. The secondary objective was relationship between the occurrence of hypoglycaemia before and after the switch.

Results: Data from 107 patients on Gla-300 have been analysed. Switching to insulin Gla-300 significantly reduced HbA1c (∆ -1.0%, p=0.000), FPG (∆ - 1.7mmol/l, p=0.000) and PPG (∆ -2.8mmol/l, p=0.000). More patients achieved target HbA1c concentrations (≤ 7%) after the switch to Gla-300 (8.4% before vs. 32% after the switch). 90.2% of subjects reported reduced number of hypoglycaemic events after switching to Gla-300.

Conclusion: Switching to insulin Gla-300 proved to be safe and effective for patients with both, T1D and T2D.