Glycemic Variability and Time in Range During Self-titration of Once Daily Insulin Glargine 300 U/ml Versus Neutral Protamine Hagedorn Insulin in Insulin-naïve Chinese Type 2 Diabetes Patients

Ling, J. M.; Poon, Emily; Yang, Aimin; Yeung, Theresa; Loo, Kit-Man; Ozaki, Risa; Ronald, C.; Luk, Andrea; Kong, Alice Pik Shan; Chan, Juliana C.N.; Chow, Elaine

doi:10.1007/s13300-021-01046-6

Cited by 5 publications

(11 citation statements)

References 18 publications

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“…Eventually, 35 publications (31 RCTs) met the planned inclusion criteria. 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 Among them, 30 papers answered Q1, 11 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 26 , 27 , 28 , 29 , 30 ,…”

Section: Resultsmentioning

confidence: 99%

“…After reviewing titles and abstracts, 515 references were deemed eligible for full‐text screening. Eventually, 35 publications (31 RCTs) met the planned inclusion criteria 9–43 . Among them, 30 papers answered Q1, 11,13–24,26–31,33–43 2 papers answered Q2, 10,12 and 3 papers answered Q4 9,25,32 .…”

Section: Resultsmentioning

confidence: 99%

“…Thirty papers (26 RCTs) were eligible for this research question. 11 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 26 , 27 , 28 , 29 , 30 , 31 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 Based on different administration times of basal insulins, we classified these RCTs into four categories: (1) one basal insulin injected at bedtime versus another basal insulin injected at bedtime; (2) one basal insulin injected at morning time versus another basal insulin injected at morning time. (3) one basal insulin injected at morning time versus another basal insulin injected at bedtime; and (4) one basal insulin injected at morning time versus the same insulin injected at bedtime.…”

Section: Q1 Effectiveness and Safety Among Five Basal Insul...mentioning

confidence: 99%

“…One RCT with 50 patients was included in this comparison. 11 Evidence on the following outcomes favored glargine: U‐300 including less hypoglycemia <3.0 mmol/L at 6 months (174 fewer/1000, 95% CI 211 fewer−126 more), less hypoglycemia <3.9 mmol/L at 3 months (436 fewer/1000, 95% CI 584 fewer−148 fewer), less hypoglycemia <3.9 mmol/L at 6 months (480 fewer/1000, 95% CI 613 fewer−200 fewer), less nocturnal hypoglycemia <3.0 mmol/L at 6 months (155 fewer/1000, 95% CI 172 fewer−165 more), less nocturnal hypoglycemia <3.9 mmol/L at 3 months (413 fewer/1000, 95% CI 100 fewer−∞), and less nocturnal hypoglycemia <3.9 mmol/L at 6 months (348 fewer/1000, 95% CI 383 fewer−74 fewer). None of the observed summary effects favored NPH.…”

Section: Q1 Effectiveness and Safety Among Five Basal Insul...mentioning

confidence: 99%

“…No eligible RCT compared the different initial starting doses for glargine U‐300, degludec U‐100, and NPH. Among the 35 included RCTs, 8 indicated that the initial dose for glargine U‐300 was 0.20 U/kg/day, 11 , 15 , 16 , 17 , 18 , 20 , 21 , 35 from 0.10 U/kg/day to 0.20 U/kg/day for degludec U‐100, 13 , 15 , 16 , 18 , 21 , 22 , 34 , 37 from 0.11 U/kg/day to 0.23 U/kg/day for NPH, 11 , 14 , 26 , 31 , 33 , 39 , 41 , 42 respectively in Supplementary Table S6 .…”

Section: Q2 Initial Optimal Dose (U/kg/day) For Initiation ...mentioning

confidence: 99%

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Effectiveness, safety, initial optimal dose, and optimal maintenance dose range of basal insulin regimens for type 2 diabetes: A systematic review with meta‐analysis

Luo

Xia

Zhao³

et al. 2023

Journal of Diabetes

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Aims To investigate the effectiveness, safety, optimal starting dose, optimal maintenance dose range, and target fasting plasma glucose of five basal insulins in insulin‐naïve patients with type 2 diabetes mellitus. Methods MEDLINE, EMBASE, Web of Science, and the Cochrane Library were searched from January 2000 to February 2022. The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines were followed and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach was adopted. The registration ID is CRD42022319078 in PROSPERO. Results Among 11 163 citations retrieved, 35 publications met the planned criteria. From meta‐analyses and network meta‐analyses, we found that when injecting basal insulin regimens at bedtime, the optimal choice in order of most to least effective might be glargine U‐300 or degludec U‐100, glargine U‐100 or detemir, followed by neutral protamine hagedorn (NPH). Injecting glargine U‐100 in the morning may be more effective (ie, more patients archiving glycated hemoglobin < 7.0%) and lead to fewer hypoglycemic events than injecting it at bedtime. The optimal starting dose for the initiation of any basal insulins can be 0.10–0.20 U/kg/day. There is no eligible evidence to investigate the optimal maintenance dose for basal insulins. Conclusions The five basal insulins are effective for the target population. Glargine U‐300, degludec U‐100, glargine U‐100, and detemir lead to fewer hypoglycemic events than NPH without compromising glycemic control.

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