OBJECTIVE:Elderly patients with type 2 diabetes mellitus (T2DM) present therapeutic challenges related to co-morbidities, treatment adherence, and safety. This study examines the efficacy and safety of insulin glargine compared to other glucose-lowering interventions in younger and older adults. METHODS: In this pooled analysis of 24-week data from nine prospective open-label, multicenter, phase 3/4, two-arm, parallel-group, randomized controlled trials, patients with T2DM aged 18-80 years receivedinsulin glargine (used as a basal insulin regimen) or comparators (including rosiglitazone, pioglitazone, insulin lispro, insulin lispro 75/25, NPH insulin, NPH insulin 30/70, and lifestyle/dietary measures). Endpoints included change from baseline to week 24 in: glycated hemoglobin; fasting plasma glucose; body weight; body mass index; insulin dose; incidence of nocturnal, daytime, or any hypoglycemia. Results were stratified by age (<65, ≥65, 65-74, and ≥75 years) and treatment (insulin glargine or comparator). RESULTS: A total of 2,938 patients were included (2,263 aged <65 years, 675 aged ≥65 years). Similar levels of glycemic control were achieved in both younger (<65 years) and older (≥65 years) patients with T2DM. Insulin glargine was associated with better glycemic control and a reduced incidence of daytime and any hypoglycemia versus comparator interventions in both younger and older T2DM patients. CONCLUSION: This analysis suggests that insulin glargine may represent a safe option to improve glycemic control in older patients with T2DM.
RCT Entities:
OBJECTIVE: Elderly patients with type 2 diabetes mellitus (T2DM) present therapeutic challenges related to co-morbidities, treatment adherence, and safety. This study examines the efficacy and safety of insulin glargine compared to other glucose-lowering interventions in younger and older adults. METHODS: In this pooled analysis of 24-week data from nine prospective open-label, multicenter, phase 3/4, two-arm, parallel-group, randomized controlled trials, patients with T2DM aged 18-80 years received insulin glargine (used as a basal insulin regimen) or comparators (including rosiglitazone, pioglitazone, insulin lispro, insulin lispro 75/25, NPH insulin, NPH insulin 30/70, and lifestyle/dietary measures). Endpoints included change from baseline to week 24 in: glycated hemoglobin; fasting plasma glucose; body weight; body mass index; insulin dose; incidence of nocturnal, daytime, or any hypoglycemia. Results were stratified by age (<65, ≥65, 65-74, and ≥75 years) and treatment (insulin glargine or comparator). RESULTS: A total of 2,938 patients were included (2,263 aged <65 years, 675 aged ≥65 years). Similar levels of glycemic control were achieved in both younger (<65 years) and older (≥65 years) patients with T2DM. Insulin glargine was associated with better glycemic control and a reduced incidence of daytime and any hypoglycemia versus comparator interventions in both younger and older T2DM patients. CONCLUSION: This analysis suggests that insulin glargine may represent a safe option to improve glycemic control in older patients with T2DM.
Authors: S E Inzucchi; R M Bergenstal; J B Buse; M Diamant; E Ferrannini; M Nauck; A L Peters; A Tsapas; R Wender; D R Matthews Journal: Diabetologia Date: 2012-04-20 Impact factor: 10.122
Authors: Louise B Russell; Elmira Valiyeva; Sheila H Roman; Leonard M Pogach; Dong-Churl Suh; Monika M Safford Journal: Diabetes Care Date: 2005-07 Impact factor: 19.112
Authors: Reinhard G Bretzel; Ulrike Nuber; Wolfgang Landgraf; David R Owens; Clare Bradley; Thomas Linn Journal: Lancet Date: 2008-03-29 Impact factor: 79.321