Healthcare Professional Check

This website is intended for diabetes healthcare professionals. Click one of the options below to access the content.

You are here

Safety and efficacy of insulin glargine 300 u/mL compared with other basal insulin therapies in patients with type 2 diabetes mellitus: a network meta-analysis

Freemantle, N et al.

Gla-300 is a basal insulin that was recently approved by the European Commission and the US Food and Drug Administration. Gla-300 is a concentrated formulation of Gla-100; it has a flatter and more prolonged pharmacokinetic and pharmacodynamic profile than Gla-100. In clinical trials with treat-to-target designs, Gla-300 demonstrated comparable HbA1c reduction to Gla-100 but with a lower risk of hypoglycaemia. The reduced risk of hypoglycaemia with Gla-300 has been attributed to the improved pharmacokinetic and pharmacodynamic properties of insulin glargine when given at higher concentrations.

No randomized controlled trials have compared Gla-300 with other available basal insulin formulations. This makes it difficult to establish the role of Gla-300 within current treatment protocols. In the absence of randomized clinical trials, a NMA may help to estimate the comparative effects of multiple interventions using indirect evidence.

In the current study, a comprehensive literature search and NMA was performed to indirectly compare the efficacy and safety of Gla-300 with other available basal insulin formulations in the treatment of type 2 diabetes. A total of 41 studies were included in the NMA; these studies evaluated Gla-300, Gla-100, IDeg, IDet, premixed insulin, and NPH insulin.

Results indicated that the change in HbA1c was comparable between Gla-300 and IDet (difference −0.08), NPH (0.01), IDeg (−0.12) and premixed insulin (0.26).

Change in body weight was comparable between Gla-300 and IDet (0.69), NPH insulin (−0.76) and IDeg (−0.63), but significantly lower compared with premixed insulin (−1.83). For nocturnal hypoglycaemia, Gla-300 was associated with a significantly lower rate versus NPH (risk ratio: 0.18) and premixed insulin (0.36); no significant differences were noted between Gla-300 and IDet (0.52) and IDeg (0.66). For symptomatic hypoglycaemia, no significant differences were observed between Gla-300 and IDet (0.63), and NPH (0.66) and IDeg (0.55).

Based on these findings, the researchers concluded that Gla-300 appears to provide comparable glycaemic control to other available basal insulin formulations, but with a lower risk of nocturnal hypoglycaemia compared with premixed and NPH insulin. However, they noted that while this NMA (performed in the absence of randomized controlled trials directly comparing Gla-300 with other basal insulin formulations) helps to synthesize available information, it is no substitute for head-to-head clinical trials. 

Courses are now online!

Register for the Insulin Educational program and start any available content whenever you want. You can sign up to the E-alert list to be notified when new courses or course modules are uploaded.


Search this site

Search form


 

Developed by Elsevier B.V., supported by an unrestricted educational grant from Novo Nordisk