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Open Access 01-02-2020 | Insulin Glargine | Commentary
Commentary to “Differential Effect of Hypoalbuminemia on Hypoglycemia on Type 2 Diabetes Patients Treated with Insulin Glargine 300 U/ml and Insulin Degludec” by Kawaguchi et al. Diabetes Therapy 2019
Published in: Diabetes Therapy | Issue 2/2020
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Two publications from a small-scale cross-over study comparing insulin glargine 300 units/mL (glargine U300) with insulin degludec (degludec) in 30 patients with type 2 diabetes have been published recently.
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The results from these studies indicate that glargine U300 was associated with a lower percentage of time in hypoglycaemia and that this lower risk of hypoglycaemia was in patients with low albumin concentrations.
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However, this study was limited by the lack of adjustment in starting insulin dose, the short study period to assess continuous glucose monitoring and the heterogeneous background therapies of the patient group.
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A post hoc analysis of the DEVOTE cardiovascular outcomes trial did not indicate an increased relative risk of hypoglycaemia for degludec versus insulin glargine 100 units/mL (glargine U100) and did not show any albumin-related safety signal concerning degludec.
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We acknowledge that glargine U100 and U300 have different pharmacokinetic profiles that likely explain the higher hypoglycaemia risk of glargine U100 compared with glargine U300 and degludec.
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