Ana Díez-Fernández1,2, Iván Cavero-Redondo3, Jesús Moreno-Fernández4, Diana P Pozuelo-Carrascosa1, Miriam Garrido-Miguel1, Vicente Martínez-Vizcaíno1,5. 1. Health and Social Research Centre, Universidad de Castilla-La Mancha, C/ Santa Teresa Jornet, s/n, 16071, Cuenca, Spain. 2. Faculty of Nursing, Universidad de Castilla-La Mancha, Camino del Pozuelo, s/n, 16071, Cuenca, Spain. 3. Health and Social Research Centre, Universidad de Castilla-La Mancha, C/ Santa Teresa Jornet, s/n, 16071, Cuenca, Spain. Ivan.cavero@uclm.es. 4. Department of Endocrinology and Nutrition, Ciudad Real General University Hospital, C/ Obispo Rafael Torija, s/n, 13005, Ciudad Real, Spain. 5. Faculty of Health Sciences, Autonomous University of Chile, 5 y Medio Norte, 1670, Talca, Chile.
Abstract
AIMS: To assess the effectiveness of insulin glargine 300 ui/ml (Gla-300) compared with insulin glargine 100 ui/ml (Gla-100) on reducing nocturnal hypoglycemia and improving glycemic control in type 1 and type 2 diabetes patients. METHODS: We systematically searched in Medline, Embase, Web of Science, and Cochrane Central Register of Controlled Trials until July 4th, 2018. This study was registered with PROSPERO (CRD42017080134). We included randomized clinical trials comparing Gla-300 versus Gla-100 reporting the rate ratio or number of events of nocturnal hypoglycemia and HbA1c levels percentage or mmol/mol-1. The main outcome was the incidence rate ratio (RR) of nocturnal hypoglycemia events. The heterogeneity of results across studies was assessed using the I2 statistic. Fixed- and random-effect models were used to estimate pooled RRs. RESULTS: Nine studies were included in the meta-analysis, including 3977 adult patients. Compared with Gla-100, the use of Gla-300 reduced confirmed nocturnal hypoglycemia [RR = 0.81 (0.69, 0.95)] and clinically significant nocturnal hypoglycemia [RR = 0.75 (0.63, 0.91)]. Reductions in clinically significant nocturnal hypoglycemia events [RR = 0.64 (0.42, 0.97)] in type 1 diabetes patients were found. A small decrease in HbA1c levels in favor of Gla-300 in the pooled sample was identified [ES = - 0.08 (95% CI - 0.14, - 0.01)]. CONCLUSIONS: The best current evidence indicates that Gla-300 reduces the incidence of nocturnal hypoglycemia with slight improvements in glycemic control compared with Gla-100 in both type 1 and type 2 diabetes adult patients.
AIMS: To assess the effectiveness of insulin glargine 300 ui/ml (Gla-300) compared with insulin glargine 100 ui/ml (Gla-100) on reducing nocturnal hypoglycemia and improving glycemic control in type 1 and type 2 diabetespatients. METHODS: We systematically searched in Medline, Embase, Web of Science, and Cochrane Central Register of Controlled Trials until July 4th, 2018. This study was registered with PROSPERO (CRD42017080134). We included randomized clinical trials comparing Gla-300 versus Gla-100 reporting the rate ratio or number of events of nocturnal hypoglycemia and HbA1c levels percentage or mmol/mol-1. The main outcome was the incidence rate ratio (RR) of nocturnal hypoglycemia events. The heterogeneity of results across studies was assessed using the I2 statistic. Fixed- and random-effect models were used to estimate pooled RRs. RESULTS: Nine studies were included in the meta-analysis, including 3977 adult patients. Compared with Gla-100, the use of Gla-300 reduced confirmed nocturnal hypoglycemia [RR = 0.81 (0.69, 0.95)] and clinically significant nocturnal hypoglycemia [RR = 0.75 (0.63, 0.91)]. Reductions in clinically significant nocturnal hypoglycemia events [RR = 0.64 (0.42, 0.97)] in type 1 diabetespatients were found. A small decrease in HbA1c levels in favor of Gla-300 in the pooled sample was identified [ES = - 0.08 (95% CI - 0.14, - 0.01)]. CONCLUSIONS: The best current evidence indicates that Gla-300 reduces the incidence of nocturnal hypoglycemia with slight improvements in glycemic control compared with Gla-100 in both type 1 and type 2 diabetes adult patients.
Entities:
Keywords:
HbA1c; meta-analysis; Hypoglycemia; Insulin glargine; Type 1 diabetes; Type 2 diabetes
Authors: Brian Godman; Magdalene Wladysiuk; Stuart McTaggart; Amanj Kurdi; Eleonora Allocati; Mihajlo Jakovljevic; Francis Kalemeera; Iris Hoxha; Anna Nachtnebel; Robert Sauermann; Manfred Hinteregger; Vanda Marković-Peković; Biljana Tubic; Guenka Petrova; Konstantin Tachkov; Juraj Slabý; Radka Nejezchlebova; Iva Selke Krulichová; Ott Laius; Gisbert Selke; Irene Langner; András Harsanyi; András Inotai; Arianit Jakupi; Svens Henkuzens; Kristina Garuolienė; Jolanta Gulbinovič; Patricia Vella Bonanno; Jakub Rutkowski; Skule Ingeberg; Øyvind Melien; Ileana Mardare; Jurij Fürst; Sean MacBride-Stewart; Carol Holmes; Caridad Pontes; Corinne Zara; Marta Turu Pedrola; Mikael Hoffmann; Vasileios Kourafalos; Alice Pisana; Rita Banzi; Stephen Campbell; Bjorn Wettermark Journal: Biomed Res Int Date: 2021-10-11 Impact factor: 3.411