Browsing by Subject "BASAL INSULIN"

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  • Ritzel, Robert; Roussel, Ronan; Giaccari, Andrea; Vora, Jiten; Brulle-Wohlhueter, Claire; Yki-Järvinen, Hannele (2018)
    AimsTo investigate the efficacy and safety of insulin glargine 300U/mL (Gla-300) vs insulin glargine 100U/mL (Gla-100) over 12months in a patient-level meta-analysis, using data from the EDITION studies in people with type 2 diabetes (T2DM). Methods EDITION 1, 2 and 3 were multicentre, randomized, open-label, 2-arm, parallel-group, treat-to-target phase IIIa studies. Similar study designs and endpoints enabled a meta-analysis to be conducted. ResultsReductions in glycated haemoglobin (HbA1c) were better sustained over 12months with Gla-300 than with Gla-100 (least squares [LS] mean difference in change from baseline: -0.10 % [95% confidence interval {CI} -0.18 to -0.02] or -1.09mmol/mol [95% CI -2.01 to -0.20]; P=.0174). Risk of confirmed (3.9mmol/L) or severe hypoglycaemia was 15% lower with Gla-300 vs Gla-100 at night (relative risk 0.85 [95% CI 0.77-0.92]) and 6% lower at any time of day (relative risk 0.94 [95% CI 0.90-0.98]). Rates of hypoglycaemia were 18% lower with Gla-300 vs Gla-100 at night (rate ratio 0.82 [95% CI 0.67-0.99]), but comparable at any time of day. HbA1c ConclusionsIn a broad population of people with T2DM over 12months, use of Gla-300 provided more sustained glycaemic control and significantly lower hypoglycaemia risk at night and at any time of day compared with Gla-100.
  • Paldanius, Päivi Maria (2020)
    Type 2 diabetes mellitus (T2DM) is a complex and progressive chronic disease characterised by elevating hyperglycaemia and as-sociated need to gradually intensify therapy in order to achieve and maintain glycaemic control. Treating hyperglycaemia with se-quential therapy is proposed to allow holistic assessment of the efficacy and risk-to-benefit ratio of each added component. How-ever, there is an array of evidence supporting the scientific rationale for using synergistic, earlier, modern drug combinations to achieve glycaemic goals, delay the deterioration of glycaemic control, and, therefore, potentially preserve or slow down the declin-ing β-cell function. Additionally, implementation of early combination(s) may lead to opportunities to combat clinical inertia and other hurdles to optimised disease management outcomes. This review aims to discuss the latest empirical evidence for long-term clinical benefits of this novel strategy of early combination in people with newly diagnosed T2DM versus the current widely-im-plemented treatment paradigm, which focuses on control of hyperglycaemia using lifestyle interventions followed by sequentially intensified (mostly metformin-based) monotherapy. The recent reported Vildagliptin Efficacy in combination with metfoRmin For earlY treatment of T2DM (VERIFY) study results have provided significant new evidence confirming long-term glycaemic durability and tolerability of a specific early combination in the management of newly diagnosed, treatment-naïve patients world-wide. These results have also contributed to changes in clinical treatment guidelines and standards of care while clinical imple-mentation and individualised treatment decisions based on VERIFY results might face barriers beyond the existing scientific evi-dence.