학술논문
Switching from Neutral Protamine Hagedorn (NPH) Insulin to Insulin Glargine 300 U/mL in Older and Younger Patients with Type 2 Diabetes: A Post Hoc Analysis of a Multicenter, Prospective, Observational Study
Original Research
Original Research
Document Type
Report
Source
Diabetes Therapy. February 2022, Vol. 13 Issue 2, p301, 10 p.
Subject
Language
English
ISSN
1869-6953
Abstract
Author(s): B. Wolnik [sup.1] , A. Hryniewiecki [sup.2] , D. Pisarczyk-Wiza [sup.3] , T. Szczepanik [sup.4] , T. Klupa [sup.5] Author Affiliations: (1) grid.11451.30, 0000 0001 0531 3426, Department of [...]
Introduction Older age and longer disease duration are key risk factors for hypoglycemia in patients with type 2 diabetes (T2D) who receive insulin. Previous studies have shown that insulin glargine 300 U/mL (Gla-300) improves glycemic control and reduces the risk of hypoglycemia, but whether this effect is observed in older patients switching from neutral protamine Hagedorn (NPH) insulin is unclear. Methods In this multicenter, observational study involving patients with T2D aged [greater than or equal to] 18 years with glycated hemoglobin (HbA.sub.1c) [greater than or equal to] 8%, we compared the safety and effectiveness of switching from NPH insulin to Gla-300 in subgroups of patients differing by age ( 13 years). Results A total of 469 participants were included in the study. From baseline to 6 months after switching to Gla-300, mean HbA.sub.1c decreased from 9.23% to 8.13% (p < 0.001) among patients aged [less than or equal to] 65 years (224 patients), and from 9.15% to 8.20% (p 65 years (245 patients). The proportion of patients with [greater than or equal to] 1 episodes of hypoglycemia decreased from 19.1% to 13.6% (p = 0.11) among those aged [less than or equal to] 65 years, and from 27.6% to 13.0% (p 65 years; the reduction was significantly greater in those aged > 65 years (p = 0.001). The reduction in HbA.sub.1c was greater in those with a disease duration [less than or equal to] 13 years (p = 0.007), but the reduction in hypoglycemia was greater in those with a disease duration > 13 years (p < 0.0003). Conclusion The switch from NPH insulin to Gla-300 improved glycemic control in older patients with T2D and in those with a longer disease duration. Older patients with T2D and those with a longer disease duration benefited even more from the switch to Gla-300 than younger patients and those with a shorter disease duration, with significantly greater reductions in the risk of hypoglycemia. 5yeFea9pYCAx5gvBCiEqsAVideo Abstract Infographic
Introduction Older age and longer disease duration are key risk factors for hypoglycemia in patients with type 2 diabetes (T2D) who receive insulin. Previous studies have shown that insulin glargine 300 U/mL (Gla-300) improves glycemic control and reduces the risk of hypoglycemia, but whether this effect is observed in older patients switching from neutral protamine Hagedorn (NPH) insulin is unclear. Methods In this multicenter, observational study involving patients with T2D aged [greater than or equal to] 18 years with glycated hemoglobin (HbA.sub.1c) [greater than or equal to] 8%, we compared the safety and effectiveness of switching from NPH insulin to Gla-300 in subgroups of patients differing by age ( 13 years). Results A total of 469 participants were included in the study. From baseline to 6 months after switching to Gla-300, mean HbA.sub.1c decreased from 9.23% to 8.13% (p < 0.001) among patients aged [less than or equal to] 65 years (224 patients), and from 9.15% to 8.20% (p 65 years (245 patients). The proportion of patients with [greater than or equal to] 1 episodes of hypoglycemia decreased from 19.1% to 13.6% (p = 0.11) among those aged [less than or equal to] 65 years, and from 27.6% to 13.0% (p 65 years; the reduction was significantly greater in those aged > 65 years (p = 0.001). The reduction in HbA.sub.1c was greater in those with a disease duration [less than or equal to] 13 years (p = 0.007), but the reduction in hypoglycemia was greater in those with a disease duration > 13 years (p < 0.0003). Conclusion The switch from NPH insulin to Gla-300 improved glycemic control in older patients with T2D and in those with a longer disease duration. Older patients with T2D and those with a longer disease duration benefited even more from the switch to Gla-300 than younger patients and those with a shorter disease duration, with significantly greater reductions in the risk of hypoglycemia. 5yeFea9pYCAx5gvBCiEqsAVideo Abstract Infographic