Effects of Glargine u300 on Low-Density Lipoprotein (LDL), Triglyceride(TG) and Blood Glucose Levels: Real-Life Outcomes

Yıl 2022, , 137 - 142, 31.08.2022

Ahmet Toygar Kalkan , Bilge Başdoğan , Özge Özer , Fatma Belgin Efe , Nur Kebapçı , Aysen Akalın , Göknur Yorulmaz

https://doi.org/10.25048/tudod.1092781

Öz

Aim: In real life, we aimed to evaluate the effect of new generation insulin glargine u-300 on fasting blood glucose, HbA1c, LDL and
triglyceride levels.
Material and Methods: This is a retrocspective cohort study. We retrospectively reviewed patients who applied to the Endocrinology
and metabolism outpatient clinic of Eskişehir Osmangazi University in 2019, whose old generation basal insulin was replaced with
glargine u-300 and whose antilipidemic treatment was not changed. We compared fasting blood glucose(mg/dl), HbA1c(%), LDL(mg/
dl) and triglyceride(mg/dl) values at baseline and after 3 months. We also evaluated these data by separating them into genders. Shapiro–
Wilk normality test was performed for continuous variables. Wilcoxon Signed Ranks test was performed for non-normally distributed
variables.
Results: Data concerning 109 patients were analysed. The fasting blood glucose average and median value decreased in control after
starting glarjin u-300. However, it was not statistically different (p=0.06). The HbA1c control value (8.8%) decreased statistically
significantly compared to the baseline value (9.61%) (p<0.001). The LDL control value(116.6mg/dl) also decreased statistically
significantly compared to the baseline value (124mg/dl) (p<0.001). Although Hba1c and LDL were significant, there was no significant
difference in terms of triglycerides. When we evaluate the sexes separately, we see that fasting blood glucose, HbA1c, LDL and triglyceride
values decrease more in men. Fasting blood glucose, which does not show statistically significant difference in women, has been shown
to decrease significantly in men.
Conclusion: We think that showing statistically significant HbA1c and LDL decline with the Glarjin u-300 in real-life data is promising
for further studies. At the same time, despite the significant decrease in fasting blood glucose in men, the inability to show it in women
should be considered as data that need further evaluation.

Anahtar Kelimeler

Glargine u-300, LDL, HbA1c, triglyceride

Glargine u300'ün Düşük Yoğunluklu Lipoprotein (LDL), Trigliserid (TG) ve Kan Şekeri Düzeyleri Üzerindeki Etkileri: Gerçek Yaşam Sonuçları

Öz

Amaç: Gerçek hayatta yeni nesil insülin glarjin u-300'ün açlık kan şekeri, HbA1c, LDL ve trigliserit düzeylerine etkisini değerlendirmeyi
amaçladık.
Gereç ve Yöntemler: Eskişehir Osmangazi Üniversitesi Endokrinoloji ve Metabolizma polikliniğine 2019 yılında başvuran, eski nesil
bazal insülin yerine glargine u-300 kullanılan ve antilipidemik tedavisi değişmeyen hastaları geriye dönük olarak inceledik. Başlangıçta ve
3 ay sonra açlık kan şekeri(mg/dl), HbA1c(%), LDL(mg/dl) ve trigliserit(mg/dl) değerlerini karşılaştırdık. Biz de bu verileri cinsiyetlere continayırarak
değerlendirdik. Sürekli değişkenler için Shapiro-Wilk normallik testi yapıldı. Normal dağılım gösteren değişkenler için paired
sample t testi, normal dağılım göstermeyen değişkenler için Wilcoxon Signed Ranks testi uygulandı.
Bulgular: 109 hasta ile ilgili veriler analiz edildi. Açlık kan şekeri ortalaması ve medyan değeri kontrolde glarjin u-300'e başladıktan
sonra azaldı. Ancak istatistiksel olarak farklı değildi(p=0,06). HbA1c kontrol değeri (%8,8) başlangıç değerine (%9,61) göre istatistiksel
olarak anlamlı derecede azaldı (p<0,001). LDL kontrol değeri (116,6mg/dl) ayrıca başlangıç değerine (124mg/dl) kıyasla istatistiksel
olarak önemli ölçüde azaldı (p<0,001). Hba1c ve LDL anlamlı olmasına rağmen trigliseridler açısından anlamlı fark yoktu. Cinsiyetleri
ayrı ayrı değerlendirdiğimizde erkeklerde açlık kan şekeri, HbA1c, LDL ve trigliserit değerlerinin daha fazla düştüğünü görüyoruz.
Kadınlarda istatistiksel olarak anlamlı farklılık göstermeyen açlık kan şekerinin erkeklerde önemli ölçüde düştüğü gösterilmiştir.
Sonuç: Gerçek hayat verilerinde Glarjin u-300 ile istatistiksel olarak anlamlı HbA1c ve LDL düşüşü göstermenin daha sonraki
çalışmalar için umut verici olduğunu düşünüyoruz. Aynı zamanda erkeklerde açlık kan şekerindeki önemli düşüşe rağmen kadınlarda
gösterilememesi daha fazla değerlendirilmesi gereken veriler olarak değerlendirilmelidir.

Anahtar Kelimeler

Glargine u-300, LDL, HbA1c, triglyceride

Kaynakça

• 1. Saeedi P, Petersohn I, Salpea P, Malanda B, Karuranga S, Unwin N, Colagiuri S, Guariguata L, Motala AA, Ogurtsova K, Shaw JE, Bright D, Williams R ve Committee., IDF Diabetes Atlas. Diabetes Res Clin Pract. 2019 Nov; 157: 107843. doi: 10.1016 / j.diabres.2019.107843. Epub 2019 Sep 10.
• 2. IDF Diabetes Atlas, 4th ed. Brussels, Belgium: International Diabetes Federation; 2009. Federation., International Diabetes.
• 3. IDF Diabetes Atlas, 5th ed. Brussels, Belgium: International Diabetes Federation; 2011. Federation., International Diabetes.
• 4. IDF Diabetes Atlas, 6th ed. Brussels, Belgium: International Diabetes Federation; 2013. Federation., International Diabetes.
• 5. IDF Diabetes Atlas, 7th ed. Brussels, Belgium: International Diabetes Federation; 2015. Federation., International Diabetes.
• 6. IDF Diabetes Atlas, 8th ed. Brussels, Belgium: International Diabetes Federation; 2017. Federation., International Diabetes.
• 7. Diabetes, Other Risk Factors, and 12-Yr Cardiovascular Mortality for Men Screened in the Multiple Risk Factor Intervention Trial Diabetes Care 1993 Feb; 16 (2): 434-444.https: //doi.org/10.2337/diacare.16.2.434. Jeremiah Stamler, MD, Olga Vaccaro, MD, James D Neaton, PHD, Deborah Wentworth, MPH and The Multiple Risk Factor Intervention Trial Research Group.
• 8. Morbidity and mortality in diabetics in the Framingham population. Sixteen year follow-up study.Diabetes. 1974 Feb;23(2):105-11. Garcia MJ, McNamara PM, Gordon T, Kannel WB.
• 9. Atherogenesis in diabetes.Arterioscler Thromb. 1992 Jun;12(6):647-56. EL, Bierman.
• 10. Effect of insulin treatment on plasma oxidized LDL/LDL-cholesterol ratio in type 2 diabetic patients.Diabetes Metab. 2006 Dec;32(6):625-31. Galland F, Duvillard L, Petit JM, Lagrost L, Vaillant G, Brun JM, Gambert P, Vergès B.
• 11. T. New insulin glargine 300 Units mL-1 provides a more even activity profile and prolonged glycemic control at steady state compared with insulin glargine 100 Units . mL-1. Diabetes Care 2015 Apr;38(4):637-43. Becker RH, Dahmen R, Bergmann K, Lehmann A, Jax T, Heise.
• 12. Glycaemic control and hypoglycaemia with new insulin glargine 300 U/ml versus insulin glargine 100 U/ml in people with type 2 diabetes using basal insulin and oral antihyperglycaemic drugs. Diabetes Obes Metab 2015 Dec;17(12):1142-9. Yki-Järvinen H, Bergenstal RM, Bolli GB, Ziemen M, Wardecki M, Muehlen-Bartmer I, et al.
• 13. New insulin glargine 300 units/mL versus glargine 100 units/mL in people with type 2 diabetes using basal and mealtime insulin: glucose control and hypoglycemia in a 6-month randomized controlled trial (EDITION 1). Diabetes Care 2014 Oct;37(10):2755-62. Riddle MC, Bolli GB, Ziemen M, Muehlen-Bartmer I, Bizet F, Home PD, et al.
• 14. Clinical outcomes in realworld patients with type 2 diabetes switching from first- to second-generation basal insulin analogues. Diabetes Obes Metab 2018 Sep;20(9):2148-58. Sullivan SD, Bailey TS, Roussel R, Zhou FL, Bosnyak Z, Preblick R, et al.
• 15. Real-world evidence concerning clinical and economic outcomes of switching to insulin glargine 300 units/mL vs other basal insulins in patients with type 2 diabetes using basal insulin. Diabetes Obes Metab 2018 May;20(5):1293-97. Zhou FL, Ye F, Berhanu P, Gupta VE, Gupta RA, Sung J, et al.