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Response to insulin glargine 100 U/mL treatment in newly-defined subgroups of type 2 diabetes: Post hoc pooled analysis of insulin-naïve participants from nine randomised clinical trials

Wolfgang Landgraf Orcid Logo, Gregory Bigot, Brian M. Frier, Geremia B. Bolli, David Owens Orcid Logo

Primary Care Diabetes, Volume: 17, Issue: 4, Pages: 379 - 385

Swansea University Author: David Owens Orcid Logo

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DOI (Published version): 10.1016/j.pcd.2023.04.010

Abstract

Aims: To assess insulin glargine 100 U/mL (IGlar-100) treatment outcomes according to newly-defined subgroups of type 2 diabetes mellitus (T2DM). Methods: Insulin-naïve T2DM participants (n = 2684) from nine randomised clinical trials initiating IGlar-100 were pooled and assigned to subgroups “Mild...

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Published in: Primary Care Diabetes
ISSN: 1751-9918
Published: Elsevier BV 2023
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URI: https://cronfa.swan.ac.uk/Record/cronfa63334
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spelling 2023-09-05T11:48:40.2089364 v2 63334 2023-05-02 Response to insulin glargine 100 U/mL treatment in newly-defined subgroups of type 2 diabetes: Post hoc pooled analysis of insulin-naïve participants from nine randomised clinical trials 2fd4b7c3f82c6d3bd546eff61ff944e9 0000-0003-1002-1238 David Owens David Owens true false 2023-05-02 MEDS Aims: To assess insulin glargine 100 U/mL (IGlar-100) treatment outcomes according to newly-defined subgroups of type 2 diabetes mellitus (T2DM). Methods: Insulin-naïve T2DM participants (n = 2684) from nine randomised clinical trials initiating IGlar-100 were pooled and assigned to subgroups “Mild Age-Related Diabetes (MARD)”, “Mild Obesity Diabetes (MOD)”, “Severe Insulin Resistant Diabetes (SIRD)”, and “Severe Insulin Deficient Diabetes (SIDD)”, according to age at onset of diabetes, baseline HbA1c, BMI, and fasting C-peptide using sex-specific nearest centroid approach. HbA1c, FPG, hypoglycemia, insulin dose, and body weight were analysed at baseline and 24 weeks. Results: Subgroup distribution was MARD 15.3 % (n = 411), MOD 39.8 % (n = 1067), SIRD 10.5 % (n = 283), SIDD 34.4 % (n = 923). From baseline HbA1c 8.0–9.6% adjusted least square mean reductions after 24 weeks were similar between subgroups (1.4–1.5 %). SIDD was less likely to achieve HbA1c < 7.0 % (OR: 0.40 [0.29, 0.55]) than MARD. While the final IGlar-100 dose (0.36 U/kg) in MARD was lower than in other subgroups (0.46–0.50 U/kg), it had the highest hypoglycemia risk. SIRD had lowest hypoglycemia risk and SIDD exhibited greatest body weight gain. Conclusions: IGlar-100 lowered hyperglycemia similarly in all T2DM subgroups, but level of glycemic control, insulin dose, and hypoglycemia risk differed between subgroups. Journal Article Primary Care Diabetes 17 4 379 385 Elsevier BV 1751-9918 Clustering, C-peptide, Type 2 diabetes, Randomised clinical trial, Insulin glargine 1 8 2023 2023-08-01 10.1016/j.pcd.2023.04.010 http://dx.doi.org/10.1016/j.pcd.2023.04.010 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University 2023-09-05T11:48:40.2089364 2023-05-02T15:24:12.5250696 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Wolfgang Landgraf 0000-0001-5321-7164 1 Gregory Bigot 2 Brian M. Frier 3 Geremia B. Bolli 4 David Owens 0000-0003-1002-1238 5 63334__28265__43faed1ea4a34b1db24694080d1985aa.pdf 63334.VOR.pdf 2023-08-08T15:49:32.2722769 Output 2488715 application/pdf Version of Record true Crown Copyright © 2023 Published by Elsevier Ltd on behalf of Primary Care Diabetes Europe. Distributed under the terms of a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0). true eng https://creativecommons.org/licenses/by-nc-nd/4.0/
title Response to insulin glargine 100 U/mL treatment in newly-defined subgroups of type 2 diabetes: Post hoc pooled analysis of insulin-naïve participants from nine randomised clinical trials
spellingShingle Response to insulin glargine 100 U/mL treatment in newly-defined subgroups of type 2 diabetes: Post hoc pooled analysis of insulin-naïve participants from nine randomised clinical trials
David Owens
title_short Response to insulin glargine 100 U/mL treatment in newly-defined subgroups of type 2 diabetes: Post hoc pooled analysis of insulin-naïve participants from nine randomised clinical trials
title_full Response to insulin glargine 100 U/mL treatment in newly-defined subgroups of type 2 diabetes: Post hoc pooled analysis of insulin-naïve participants from nine randomised clinical trials
title_fullStr Response to insulin glargine 100 U/mL treatment in newly-defined subgroups of type 2 diabetes: Post hoc pooled analysis of insulin-naïve participants from nine randomised clinical trials
title_full_unstemmed Response to insulin glargine 100 U/mL treatment in newly-defined subgroups of type 2 diabetes: Post hoc pooled analysis of insulin-naïve participants from nine randomised clinical trials
title_sort Response to insulin glargine 100 U/mL treatment in newly-defined subgroups of type 2 diabetes: Post hoc pooled analysis of insulin-naïve participants from nine randomised clinical trials
author_id_str_mv 2fd4b7c3f82c6d3bd546eff61ff944e9
author_id_fullname_str_mv 2fd4b7c3f82c6d3bd546eff61ff944e9_***_David Owens
author David Owens
author2 Wolfgang Landgraf
Gregory Bigot
Brian M. Frier
Geremia B. Bolli
David Owens
format Journal article
container_title Primary Care Diabetes
container_volume 17
container_issue 4
container_start_page 379
publishDate 2023
institution Swansea University
issn 1751-9918
doi_str_mv 10.1016/j.pcd.2023.04.010
publisher Elsevier BV
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
url http://dx.doi.org/10.1016/j.pcd.2023.04.010
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description Aims: To assess insulin glargine 100 U/mL (IGlar-100) treatment outcomes according to newly-defined subgroups of type 2 diabetes mellitus (T2DM). Methods: Insulin-naïve T2DM participants (n = 2684) from nine randomised clinical trials initiating IGlar-100 were pooled and assigned to subgroups “Mild Age-Related Diabetes (MARD)”, “Mild Obesity Diabetes (MOD)”, “Severe Insulin Resistant Diabetes (SIRD)”, and “Severe Insulin Deficient Diabetes (SIDD)”, according to age at onset of diabetes, baseline HbA1c, BMI, and fasting C-peptide using sex-specific nearest centroid approach. HbA1c, FPG, hypoglycemia, insulin dose, and body weight were analysed at baseline and 24 weeks. Results: Subgroup distribution was MARD 15.3 % (n = 411), MOD 39.8 % (n = 1067), SIRD 10.5 % (n = 283), SIDD 34.4 % (n = 923). From baseline HbA1c 8.0–9.6% adjusted least square mean reductions after 24 weeks were similar between subgroups (1.4–1.5 %). SIDD was less likely to achieve HbA1c < 7.0 % (OR: 0.40 [0.29, 0.55]) than MARD. While the final IGlar-100 dose (0.36 U/kg) in MARD was lower than in other subgroups (0.46–0.50 U/kg), it had the highest hypoglycemia risk. SIRD had lowest hypoglycemia risk and SIDD exhibited greatest body weight gain. Conclusions: IGlar-100 lowered hyperglycemia similarly in all T2DM subgroups, but level of glycemic control, insulin dose, and hypoglycemia risk differed between subgroups.
published_date 2023-08-01T02:41:19Z
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