Chen Liming, Wan Hailong, Han Jie, Yang Caixian, Shao Hailin, Li Jialin, Yan Wensheng, Xiao Jianzhong, Sun Yadong, Li Min, Han Yanfang, Kang Lei, Zhang Minlu
NHC Key Laboratory of Hormones and Development, Tianjin Key Laboratory of Metabolic Diseases, Chu Hsien-I Memorial Hospital and Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, China.
Department of Endocrinology, Panjin Central Hospital, Panjin, China.
Diabetes Obes Metab. 2025 Mar;27(3):1423-1431. doi: 10.1111/dom.16144. Epub 2024 Dec 18.
To evaluate the efficacy and safety of insulin glargine 300 U/mL (Gla-300) in people with uncontrolled type 2 diabetes (T2D) switching from another basal insulin (BI).
INITIATION was an interventional, single-arm, phase IV study conducted in China. In this post hoc subpopulation analysis, the efficacy and safety of switching to Gla-300 was investigated in individuals with uncontrolled T2D (HbA1c 7.5%-11.0% [58-97 mmol/mol]) with previous BI. The primary endpoint was HbA1c change at week 24. Other measures of glycaemia, hypoglycaemia, insulin dose and weight change were assessed.
Three hundred and two participants switched to Gla-300 from another BI, including 232 from insulin glargine 100 U/mL (Gla-100) and 55 from insulin degludec (IDeg). At week 24, the mean ± standard error (SE) HbA1c change from baseline was -0.87% ± 0.06% (-9.5 ± 0.7 mmol/mol; p <0.001). Significant reductions in fasting plasma glucose (least-squares mean [LSM] change -1.13 mmol/L) and fasting self-measured blood glucose (LSM change -1.36 mmol/L) were also observed (both p <0.001). The mean daily BI dose increased from 18.86 U (0.27 U/kg) at baseline to 28.83 U (0.41 U/kg) at week 24. During the 24-week treatment period, the incidence of any hypoglycaemia was 43.8% for all hypoglycaemia and 15.1% for nocturnal hypoglycaemia; the incidence of severe hypoglycaemia was low (0.7%). Minimal body weight change was documented.
Gla-300 improved glycaemic control with a relatively low hypoglycaemia risk and minimal weight gain in Chinese people with T2D uncontrolled on previous BI.
评估甘精胰岛素300 U/mL(Gla-300)在从另一种基础胰岛素(BI)转换治疗的2型糖尿病(T2D)控制不佳患者中的疗效和安全性。
INITIATION是一项在中国进行的干预性、单臂、IV期研究。在这项事后亚组分析中,研究了在之前使用过BI且T2D控制不佳(糖化血红蛋白[HbA1c]为7.5%-11.0%[58-97 mmol/mol])的个体中转换为Gla-300的疗效和安全性。主要终点是第24周时HbA1c的变化。评估了其他血糖指标、低血糖情况、胰岛素剂量和体重变化。
302名参与者从另一种BI转换为Gla-300,其中232名从甘精胰岛素100 U/mL(Gla-100)转换,55名从德谷胰岛素(IDeg)转换。在第24周时,糖化血红蛋白从基线的平均变化±标准误(SE)为-0.87%±0.06%(-9.5±0.7 mmol/mol;p<0.001)。空腹血糖(最小二乘均值[LSM]变化-1.13 mmol/L)和空腹自我测量血糖(LSM变化-1.36 mmol/L)也有显著降低(均p<0.001)。每日基础胰岛素平均剂量从基线时的18.86 U(0.27 U/kg)增加到第24周时的28.83 U(0.41 U/kg)。在24周治疗期间,任何低血糖的发生率为43.8%(所有低血糖)和15.1%(夜间低血糖);严重低血糖的发生率较低(0.7%)。记录到体重变化极小。
对于之前使用BI血糖控制不佳的中国T2D患者,Gla-300改善了血糖控制,低血糖风险相对较低,体重增加极少。