Glargin U300'ün etkinliğinin geriye yönelik olarak değerlendirilmesi: Tek merkez deneyimi

Öz

Amaç: Glargin U300'ün açlık kan şekeri (AKŞ) ve HbA1c üzerindeki uzun vadeli (12 ve 24 ay) etkilerini ve tedavi sırasında hipoglisemi gelişme sıklığını araştırmayı amaçladık. Yöntem: Ocak 2017-Ocak 2021 tarihleri arasında Dahiliye polikliniğine Tip 2 DM tanısı ile başvuran ve glargin U300 tedavisi başlanan 96 hasta retrospektif olarak incelendi. Bulgular: Tedavi başlangıcında ortalama kan glukoz düzeyi 252.19±92.55 mg/dl iken 12. ayda 203.08±82.09 mg/dl, 24. ayda 200.27±73.78 mg/dl ye kadar düşme saptandı. Benzer şekilde glargin U300 tedavisi ile HbA1c yüzdesinin hem 12 hem de 24. ayda anlamlı derecede düştüğü bulundu. Ortalama başlangıç HbA1c %9.9±1.925 iken 12. ayda 8.66±1.969 ve 24. ayda 8.51±1.430 idi. Glargin U- 300 tedavisi alan 96 hastanın altısında (%6.3) acil serviste hipoglisemi atağı geliştiği saptandı. Sonuç: Glargin U300, çalışma bulgularımızla da desteklendiği üzere hem hipoglisemi riskini azaltmada hem de hedefe yönelik glisemik kontrolü sağlamada etkin bir bazal insülindir.

Anahtar Kelimeler

• Glargine U300
• hipoglisemi
• glisemik kontrol
• uzun etkili bazal insülin

Destekleyen Kurum

yoktur

Proje Numarası

yoktur

Retrospective evaluation of the effectiveness of the glargine U300: A single center experience

Öz

Objective: We investigated the long-term (12 and 24 months) effects of glargine U300 on fasting plasma glucose (FPG), HbA1c and the incidence of hypoglycemia in patients. Method: Patients who applied to the Internal Medicine outpatient clinic with the diagnosis of Type 2 DM between January 2017 and January 2021 and were started on glargine U300 were retrospectively analyzed. Results: Gla-300 treatment significantly improved mean blood glucose levels at both 12 and 24 months (tabtotcomp.). At the beginning of the treatment, the mean blood glucose level was 252.19±92.55 mg/dl. However, it was 203.08±82.09 mg/dl at the 12th month and 200.27±73.78 on the 24th month. Similarly, with Gla-300 treatment, the percentage of HbA1c was found to be significantly lower at both 12 and 24 months. The mean initial HbA1c was 9.9±1.925%, this value was found to be 8.66±1.969 at the 12th month and 8.51±1.43 at the 24th month. Conclusion: Glargine U300 is a long-acting basal insulin that both reduces the risk of hypoglycemia and provides targeted glycemic control, as supported by our study findings.

Anahtar Kelimeler

• Glargine U300
• Hypoglycemia
• Glycemic control
• Long-acting basal insulin

Proje Numarası

yoktur

Kaynakça

1. International Diabetes Federation. IDF Diabetes Atlas. 9th ed. Brussels; 2019. http://www.diabetesatlas.org; https://www.idf.org/ aboutdiabetes/complications.html 01.04.2023 tarihinde erişilmiştir.
2. Garber AJ, Handelsman Y, Grunberger G,et al. Consensus Statement By The American Association Of Clinical Endocrinologists And American College Of Endocrinology On The Comprehensive Type 2 Diabetes Management Algorithm – 2020 Executive Summary. Endocrıne Practıce, 2020;26(1):107-139. doi:10.4158/CS-2019-0472
3. Ostenson CG, Geelhoed-Duijvestijn P, Lahtela J, Weitgasser R, Markert Jensen M, Pedersen-Bjergaard U. Self-reported non-severe hypoglycaemic events in Europe. Diabet Med. 2014;31(1):92–101. doi:10.1111/dme.12261
4. Home P, Naggar NE, Khamseh M, et al. An observational non-interventional study of people with diabetes beginning or changed to insulin analogue therapy in non-Western countries: the A1chieve study. Diabetes Res Clin Pract. 2011;94(3):352–63. doi:10.1016/j.diabres.2011.10.021
5. Brod M, Rana A, Barnett AH. Impact of self-treated hypoglycaemia in type 2 diabetes: a multinational survey in patients and physicians. Curr Med Res Opin. 2012;28(12):1947–58. doi:10.1185/03007995.2012.743457
6. Rosenzweig JL, Conlin PR, J Gonzalvo JD, et al. 2019 Endocrine Society Measures Set for Older Adults With Type 2 Diabetes Who Are at Risk for Hypoglycemia. J Clin Endocrinol Metab, 2020;105(4):969-990. doi: 10.1210/clinem/dgz250. doi:10.1210/clinem/dgz250
7. Inzucchi SE, Bergenstal RM, Buse JB, et al. Management of hyperglycemia in type 2 diabetes: a patient-centered approach: position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2012;35(6):1364–79. doi:10.2337/dc12-0413
8. Owens DR, Matfin G, Monnier L. Basal insulin analogues in the management of diabetes mellitus: what progress have we made? Diabetes Metab Res Rev. 2014;30(2):104–19. doi:10.1002/dmrr.2469

9. Maiorino MI, Petrizzo M, Capuano A, et al. The development of new basal insulins: is there any clinical advantage with their use in type 2 diabetes? Expert Opin Biol Ther. 2014;14(6):799–808. doi:10.1517/14712598.2014.895812
10. Woo VC. New insulins and new aspects in insulin delivery. Can J Diabetes. 2015;39(4):335–43. doi:10.1016/j.jcjd.2015.04.006
11. Kişioğlu SV, Demir AS, Tufekci D, et al. Clinical research of insulin glargine U300 in type 1 diabetes mellitus patients with frequent hypoglycaemia: real-world experience. Arch Med Sci Atheroscler Dis. 2021;6:e102-e108. Published 2021 Apr 20. doi:10.5114/amsad.2021.105562
12. Haliloglu O, Korkmaz M, Korkmaz OP, Sahin S, Durcan E, Siva ZO. Retrospective evaluation of insulin degludec/insulin aspart co-formulation therapy in patients with type 2 Diabetes Mellitus: A single-center experience. Ann Med Res, 2020;27(7):1961-1965. DOI: 10.5455/annalsmedres.2020.04.363
13. Wolnik B, Hryniewiecki A, Pisarczyk-Wiza D,. Szczepanik T, Klupa T. Switching from Neutral Protamine Hagedorn (NPH) Insulin to Insulin Glargine 300U/mL in Older and Younger Patients with Type 2 Diabetes: A Post Hoc Analysis of a Multicenter, Prospective, Observational Study. Diabetes Ther 2022;13:301–310. https://doi.org/10.1007/s13300-021-01199-4
14. Yki-Jarvinen H, Bergenstal R, Ziemen M, et al on behalf of the EDITION 2 Study Investigators. New Insulin Glargine 300 Units/mL Versus Glargine 100 Units/mL in People With Type 2 Diabetes Using Oral Agents and Basal Insulin: Glucose Control and Hypoglycemia in a 6-Month Randomized Controlled Trial (EDITION 2). Diabetes Care, 2014;37:3235-3243. | DOI: 10.2337/dc14-0990.
15. Duque N, Artime E, Romera I, et al. Real-World Use of Insulin Glargine U100 and U300 in Insulin-Naïve Patients with Type 2 Diabetes Mellitus: DosInGlar Study. Advances in Therapy [Internet]. 2021 May 29;38(7):3857–71. Available from: https://doi.org/10.1007/s12325-021-01773-z
16. Van Mark G, Lanzinger S, Sziegoleit S, et al. Characteristics of Patients with Type-1 or Type-2 Diabetes Receiving Insulin Glargine U300: An Analysis of 7268 Patients Based on the DPV and DIVE Registries. Advances in Therapy [Internet]. 2019 May 22;36(7):1628–41. Available from: https://doi.org/10.1007/s12325-019-00983-w
17. Tibaldi J, Hadley‐Brown M, Liebl A, et al. A comparative effectiveness study of degludec and insulin glargine 300 U/mL in insulin‐naïve patients with type 2 diabetes. Diabetes, Obesity and Metabolism [Internet]. 2019 Apr;21(4):1001–9. Available from: https://doi.org/10.1111/dom.13616
18. Zick R, Petersen B, Richter M, Haug C, SAFIR Study Group. Comparison of continuous blood glucose measurement with conventional documentation of hypoglycemia in patients with type 2 diabetes on multiple daily insulin injection therapy. Diabetes Technol Ther 2007; 9:483–92. doi: 10.1089/dia.2007.0230
19. Gehlaut RR, Dogbey GY, Schwartz FL, Marling CR, Shubrook JH. Hypoglycemia in Type 2 Diabetes--More Common Than You Think: A Continuous Glucose Monitoring Study. J Diabetes Sci Technol 2015; 9:999–1005. doi: 10.1177/1932296815581052
20. Heller SR, Peyrot M, Oates SK, Taylor AD. Hypoglycemia in patient with type 2 diabetes treated with insulin: it can happen. BMJ Open Diab Res Care, 2020;8:e001194. doi:10.1136/bmjdrc-2020-001194
21. Philis-Tsimikas A, Klonoff DC, Khunti K, Baj, et al; CONCLUDE Study Group. Risk of hypoglycaemia with insulin degludec versus insulin glargine U300 in insulin-treated patients with type 2 diabetes: the randomised, head-to-head CONCLUDE trial. Diabetologia, 2020;63(4):698-710. doi: 10.1007/s00125-019-05080-9.
22. Henderson JN, Allen KV, Deary IJ, Frier BM. Hypoglycaemia in insulin-treated Type 2 diabetes: frequency, symptoms and impaired awareness. Diabetic Medicine, 2003;20(12):1016–21.doi: 10.1046/j.1464-5491.2003.01072.x
23. Akram K, Pedersen B U, Carstensen B, Borch-Johnsen K, Thorsteinsson B. Frequency and risk factors of severe hypoglycaemia in insulin-treated Type 2 diabetes: a cross-sectional survey. Diabetic Medicine. 2006;23(7):750–6. doi: 10.1111/j.1464-5491.2006.01880.x.