Switching to insulin glargine 300 U/mL from other basal insulin analogues provides less 24-hour glucose variability in hospitalized patients with type 1 diabetes

Abstract

We aimed to assess the effect of transition to Gla-300 from other basal insulin analogues on glucose variability (GV) parameters in hospitalized patients with type 1 diabetes. Materials and Methods: Twenty six diabetic subjects, 10 M/16 F, from 19 to 67 years of age (median – 44 years), HbA1c from 6.9 to 13.2% (median –9.4%), were switched to Gla-300 from other basal analogues: Gla-100 (n=15), detemir (n=10), and degludec (n=1). Dose titration of Gla-300 was performed in accordance with current recommendations. The GV parameters: High Blood Glucose Index (HBGI), Low Blood Glucose Index (LBGI), Mean Amplitude of Glucose Excursions (MAGE), and Lability Index (LI) were derived from two 3-day 6-point glucose profiles. Results: At 6-12 day after transition to Gla-300 mean fasting and postprandial glucose decreased significantly (10.3, 8.1-12.2 vs. 7.8, 6.7-8.8 mmol/l, p=0.008 and 10.5, 7.9-14.2 vs. 7.9, 6.7-9.6 mmol/l, p=0.02 resp.). There was decrease in the values of HBGI (11.2, 6.3-18 vs. 6.9, 3.6-12.1, p=0.01) and LI (3.4, 2.1-6.1 vs. 2.2, 1.6-3.5, p=0.04), without significant LBGI increment (1.6, 0.5-4.0 vs. 2.7, 0.7-5.0 (mmol/l)2/h, р=0.16) and MAGE changes (5.7, 3.6-6.8 vs. 4.4, 3.3-6.0 mmol/l, p=0.32). The mean dose of basal insulin did not change significantly (25.5, 19-32 vs. 27, 18-38 U/day, p=0.97). Conclusion: Switching to insulin Gla-300 from other basal insulin analogues provided less 24-hour GV in hospitalized patients with type 1 diabetes.