Impact of patient and treatment characteristics on glycemic control and hypoglycemia in patients with type 2 diabetes initiated to insulin glargine or NPH: A post hoc, pooled, patient-level analysis of 6 randomized controlled trials

• Published in: Medicine (Baltimore) 2017-02, Vol.96 (5), p.e6022-e6022
• Main Authors: Porcellati, Francesca, Lin, Jay, Lucidi, Paola, Bolli, Geremia B., Fanelli, Carmine G.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Blood Glucose - drug effects; Body Mass Index; Clinical Trial/Experimental Study; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - etiology; Female; Glycated Hemoglobin - drug effects; Humans; Hypoglycemia - chemically induced; Hypoglycemic Agents - therapeutic use; Insulin Glargine - therapeutic use; Insulin, Isophane - therapeutic use; Male; Middle Aged; Obesity - complications; Randomized Controlled Trials as Topic; Treatment Outcome; Young Adult
• ISSN: 0025-7974; 1536-5964
• DOI: 10.1097/MD.0000000000006022

The goal of this post hoc analysis was to determine key patient and treatment-related factors impacting glycosylated hemoglobin (A1C) and hypoglycemia in patients with uncontrolled type 2 diabetes who were initiated to basal insulin (neutral protamine Hagedorn [NPH] or glargine). Using individual patient-level data pooled from 6 treat-to-target trials, 2600 patients with type 2 diabetes on oral antidiabetic agents initiated to insulin glargine or NPH and treated for 24 to 36 weeks were analyzed. Both treatments led to significant reduction in A1C levels compared with baseline, with no differences between treatment groups (mean ± standard deviation; glargine: -1.32 ± 1.2% vs NPH: -1.26 ± 1.2%; P = 0.15), with greater reduction in the BMI ≥30 kg/m group than in the BMI