[논문]Comparison of Insulin Glargine 300 Units/mL and 100 Units/mL in Adults With Type 1 Diabetes: Continuous Glucose Monitoring Profiles and Variability Using Morning or Evening Injections

Bergenstal, Richard M.; Bailey, Timothy S.; Rodbard, David; Ziemen, Monika; Guo, Hailing; Muehlen-Bartmer, Isabel; Ahmann, Andrew J.

doi:10.2337/dc16-0684

Comparison of Insulin Glargine 300 Units/mL and 100 Units/mL in Adults With Type 1 Diabetes: Continuous Glucose Monitoring Profiles and Variability Using Morning or Evening Injections 원문보기

Diabetes care, v.40 no.4, 2017년, pp.554 - 560

Bergenstal, Richard M. (1Park Nicollet International Diabetes Center, Minneapolis, MN) , Bailey, Timothy S. (2AMCR Institute, Escondido, CA) , Rodbard, David (3Biomedical Informatics Consultants LLC, Potomac, MD) , Ziemen, Monika (4Sanofi-Aventis Deutschland GmbH, Frankfurt am Main, Germany) , Guo, Hailing (5BDM Consulting Inc., Somerset, NJ) , Muehlen-Bartmer, Isabel (4Sanofi-Aventis Deutschland GmbH, Frankfurt am Main, Germany) , Ahmann, Andrew J. (6Oregon Health & Science University, Portland, OR)

Abstract ▼ AI-Helper

OBJECTIVEThe objective of this study was to compare glucose control in participants with type 1 diabetes receiving insulin glargine 300 units/mL (Gla-300) or glargine 100 units/mL (Gla-100) in the morning or evening, in combination with mealtime insulin.RESEARCH DESIGN AND METHODSIn this 16-week, exploratory, open-label, parallel-group, two-period crossover study (clinicaltrials.gov identifier NCT01658579), 59 adults with type 1 diabetes were randomized (1:1:1:1) to once-daily Gla-300 or Gla-100 given in the morning or evening (with crossover in the injection schedule). The primary efficacy end point was the mean percentage of time in the target glucose range (80–140 mg/dL), as measured using continuous glucose monitoring (CGM), during the last 2 weeks of each 8-week period. Additional end points included other CGM glycemic control parameters, hypoglycemia (per self-monitored plasma glucose [SMPG]), and adverse events.RESULTSThe percentage of time within the target glucose range was comparable between the Gla-300 and Gla-100 groups. There was significantly less increase in CGM-based glucose during the last 4 h of the 24-h injection interval for Gla-300 compared with Gla-100 (least squares mean difference −14.7 mg/dL [95% CI −26.9 to −2.5]; P = 0.0192). Mean 24-h glucose curves for the Gla-300 group were smoother (lower glycemic excursions), irrespective of morning or evening injection. Four metrics of intrasubject interstitial glucose variability showed no difference between Gla-300 and Gla-100. Nocturnal confirmed (<54 mg/dL by SMPG) or severe hypoglycemia rate was lower for Gla-300 participants than for Gla-100 participants (4.0 vs. 9.0 events per participant-year; rate ratio 0.45 [95% CI 0.24–0.82]).CONCLUSIONSLess increase in CGM-based glucose levels in the last 4 h of the 24-h injection interval, smoother average 24-h glucose profiles irrespective of injection time, and reduced nocturnal hypoglycemia were observed with Gla-300 versus Gla-100.

참고문헌 (17)

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Comparison of Insulin Glargine 300 Units/mL and 100 Units/mL in Adults With Type 1 Diabetes: Continuous Glucose Monitoring Profiles and Variability Using Morning or Evening Injections 원문보기

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