Insulin Glargine U100 Improved Glycemic Control and Reduced Nocturnal Hypoglycemia in Patients with Type 2 Diabetes Mellitus and Chronic Kidney Disease Stages 3 and 4

Clinical Therapeutics
Carolina C BetônicoMárcia Queiroz

Abstract

Glycemic control in patients with chronic kidney disease (CKD) is particularly hard to achieve because of a slower insulin degradation by the kidney. It might modify the long-acting insulin analogue pharmacokinetics, increasing its time-action and the risk of hypoglycemia. However, because this insulin has no peak action, it might be a more tolerable approach to patients with CKD. This hypothesis remains to be tested, because no study has thus far examined the efficacy and safety profile of long-acting basal analogues in patients with significant loss of renal function. The purpose of this study was to compare the glycemic response to treatment with glargine U100 or neutral protamine Hagedorn (NPH) insulin in patients with type 2 diabetes mellitus (T2DM) and CKD stages 3 and 4. Thirty-four patients were randomly assigned to glargine U100 or NPH insulin after a 2-way crossover open-label design. The primary end point was the difference in glycosylated hemoglobin (HbA1c) and in the number of hypoglycemic events between weeks 1 and 24, whereas secondary end points included changes in glycemic patterns, weight and body mass index, and total daily dose of insulin. HbA1c was determined by ion-exchange HPLC, and hypoglycemia was defin...Continue Reading

Citations

Nov 10, 2020·The Cochrane Database of Systematic Reviews·Thomas SemlitschKarl Horvath
Feb 20, 2021·Journal of Agricultural and Food Chemistry·Zhonghua LuoYuqing Zhao
Aug 28, 2021·Diabetic Medicine : a Journal of the British Diabetic Association·David León-JiménezJavier Escalada-San Martín

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