Switching from Neutral Protamine Hagedorn Insulin to Insulin Glargine 300 U/mL Improves Glycaemic Control and Reduces Hypoglycaemia Risk: Results of a Multicentre, Prospective, Observational Study
| العنوان: | Switching from Neutral Protamine Hagedorn Insulin to Insulin Glargine 300 U/mL Improves Glycaemic Control and Reduces Hypoglycaemia Risk: Results of a Multicentre, Prospective, Observational Study |
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| المؤلفون: | Tomasz Klupa, A Syta, D Wiza, T Szczepanik, Bogumił Wolnik |
| المصدر: | Journal of Diabetes Research, Vol 2020 (2020) Journal of Diabetes Research |
| بيانات النشر: | Hindawi Limited, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Blood Glucose, Male, Insulin degludec, medicine.medical_specialty, Article Subject, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Insulin, Isophane, Insulin Glargine, NPH insulin, Glycemic Control, Diseases of the endocrine glands. Clinical endocrinology, Endocrinology, Internal medicine, Diabetes mellitus, medicine, Humans, Hypoglycemic Agents, Prospective Studies, Prospective cohort study, Aged, Glycated Hemoglobin, Drug Substitution, Insulin glargine, business.industry, Insulin, nutritional and metabolic diseases, Type 2 Diabetes Mellitus, Middle Aged, RC648-665, medicine.disease, Hypoglycemia, Treatment Outcome, Diabetes Mellitus, Type 2, Female, Observational study, business, Research Article, medicine.drug |
| الوصف: | Type 2 diabetes mellitus (T2DM) is a major cause of morbidity and mortality worldwide and is an important public health issue. A significant proportion of insulin-treated patients with T2DM do not reach target glycated haemoglobin (HbA1c) values, which ultimately increases their risk of long-term microvascular and macrovascular complications. One potential option to improve diabetes control in these patients may be the use of new insulin formulations including second-generation basal insulin analogues such as insulin glargine 300 U/mL (Gla-300). Several published randomised controlled trials have assessed the clinical effectiveness of Gla-300, mostly versus insulin glargine 100 U/mL as well as insulin degludec. However, there is limited information about the real-world effectiveness of Gla-300 when patients are transitioned directly from neutral protamine Hagedorn (NPH) human basal insulin. The primary objective of this study was to evaluate the effectiveness of Gla-300, defined as the percentage of participants with an HbA1c reduction of ≥0.5%, 6 months after switching from NPH insulin, in participants with T2DM. Secondary objectives included the safety assessment based on the percentage of patients experiencing ≥1 episodes and the number of hypoglycaemic episodes by category: severe, symptomatic, symptomatic confirmed, diurnal or nocturnal, change in body weight, and insulin dose. A total of 469 participants completed the 6-month observation period. Mean baseline HbA1c was 9.19%. The percentage of participants with a ≥0.5% improvement in HbA1c from baseline was 71.7% at 6 months. Mean HbA1c decreased at 3 and 6 months by 0.77% (±0.98) and 1.01% (±1.12), respectively (p<0.00001 versus baseline), while fasting glycaemia decreased by 32 mg/dL and 37 mg/dL, respectively (p<0.00001 versus baseline). There were moderate increases in the doses of both Gla-300 and, if used, short-acting insulins during the 6 months of observation. The percentage of participants with ≥1 hypoglycaemia event during the preceding 4 weeks decreased significantly from baseline to 3 and 6 months, as did the proportion with symptomatic hypoglycaemia at night (p<0.00001 versus baseline). No participants had severe hypoglycaemia after a switch to Gla-300. Body mass, waist and hip circumferences, and waist : hip ratio did not change significantly. In conclusion, this large, prospective, observational study demonstrated that switching from NPH insulin to Gla-300 resulted in a significant improvement in HbA1c, with only a moderate increase in insulin dose, a decreased risk of hypoglycaemia, and no increase in body weight. |
| وصف الملف: | text/xhtml |
| تدمد: | 2314-6753 2314-6745 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::086b9eedf859fad17f1fdd83b55a82b4Test https://doi.org/10.1155/2020/8751348Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....086b9eedf859fad17f1fdd83b55a82b4 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 23146753 23146745 |
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