Department of Medicine, University of Padova, Padua, Italy.
Department of Experimental Medicine, Sapienza University, Rome, Italy.
Acta Diabetol. 2022 Oct;59(10):1317-1330. doi: 10.1007/s00592-022-01925-9. Epub 2022 Jul 21.
This study assessed comparative effectiveness of glargine 300 U/mL (Gla-300) versus degludec 100 U/mL (Deg-100) in insulin-naïve patients with T2D.
This is a retrospective, multicenter, non-inferiority study based on electronic medical records. All patients initiating Gla-300 or Deg-100 were 1:1 propensity score-matched (PSM). Linear mixed models were used to assess the changes in continuous endpoints. Incidence rates (IR) of hypoglycemia were compared using Poisson's regression models.
Nineteen centers provided data on 357 patients in each PSM cohort. HbA1c after 6 months (primary endpoint) decreased by - 1.70% (95%CI - 1.90; - 1.50) in Gla-300 group and - 169% (95%CI - 1.89; - 1.49) in Deg-100 group, confirming non-inferiority of Gla-300 versus Deg-100. Fasting blood glucose (BG) decreased by ~60 mg/dl in both groups; body weight remained unchanged. In both groups, the mean starting dose was 12U (0.15U/kg) and it was slightly titrated to 16U (0.20U/kg). IR (episodes per patient-months) of BG ≤70 mg/dl was 0.13 in Gla-300 group and 0.14 in Deg-100 group (p=0.87). IR of BG <54 mg/dL was 0.02 in both groups (p=0.49). No severe hypoglycemia occurred.
Initiating Gla-300 or Deg-100 was associated with similar improvements in glycemic control, no weight gain and low hypoglycemia rates, without severe episodes during 6 months of treatment.
本研究评估了胰岛素初治 2 型糖尿病患者中甘精胰岛素 300U/mL(Gla-300)与德谷胰岛素 100U/mL(Deg-100)的疗效比较。
这是一项基于电子病历的回顾性、多中心、非劣效性研究。所有起始 Gla-300 或 Deg-100 的患者均按 1:1 倾向评分匹配(PSM)。线性混合模型用于评估连续终点的变化。采用泊松回归模型比较低血糖发生率。
19 个中心提供了每个 PSM 队列 357 例患者的数据。Gla-300 组治疗 6 个月后 HbA1c(主要终点)下降了-1.70%(95%CI-1.90;-1.50),Deg-100 组下降了-169%(95%CI-1.89;-1.49),证实了 Gla-300 与 Deg-100 的非劣效性。两组空腹血糖(BG)均下降约 60mg/dl;体重保持不变。两组的起始平均剂量均为 12U(0.15U/kg),并略有滴定至 16U(0.20U/kg)。Gla-300 组 BG≤70mg/dl 的发生率为 0.13/患者-月,Deg-100 组为 0.14/患者-月(p=0.87)。两组 BG<54mg/dL 的发生率均为 0.02(p=0.49)。未发生严重低血糖。
起始 Gla-300 或 Deg-100 治疗与血糖控制的相似改善相关,无体重增加和低血糖发生率低,治疗 6 个月内无严重事件。