Introduction
Pharmacokinetics and Pharmacodynamics of Insulin Glargine 100 U/mL
Author year | Participants | Dose | Pharmacokinetics | Pharmacodynamics | ||||
---|---|---|---|---|---|---|---|---|
AUC (μU h/min) | Cmax (μU/mL) | Tmax (h) | GIR-AUC (g/kg) | GIRmax (mg/kg/min) | AUCmean_24h (min mg/dL) | |||
Rave 2003 [15] | Healthy men | 0.4 U/kg | 0–30 h: 2.8 | 3.0 | ||||
Kaku 2016 [14] | Healthy men | 0.4 U/kga | 0–30 h: 315, 330 | 14.6, 15.2 | 0–30 h: 1.8, 1.8 | 1.8, 1.8 | ||
Jinnouchi 2015 [13] | T1DM | Titrated to achieve FPG 80–130 mg/dL | 60,409 | |||||
Shiramoto 2015 [16] | T1DM | 0.4 U/kg | 0–24 h: 303 0–36 h: 370 | 17.3 | 8 | 0–36 h: 1.9 | 2.2 |
Combining Insulin Glargine 100 U/mL with OAMs in Patients with T2DM
Author year Country Design Duration Initiation/intensification | Treatment Group(s) | Baseline HbA1c | HbA1c Change | FBG/FPG Change | Hypoglycemia (overall, nocturnal or minor) | Body Weight/BMI Change |
---|---|---|---|---|---|---|
Randomized controlled trials
| ||||||
Mu 2012 [25] | (mean) | (mean FPG) | (mean BMI) | |||
China | Glargine+MET/GLIM or MET+GLIM (n=58) | 13.3% | −7.15% | −7.60 mmol/L | NR | +0.3 kg/m2 |
RCT | ||||||
52 weeks | ||||||
Newly diagnosed | MET/GLIM or MET+GLIM (n=67) | 13.5% | −7.15% (P=NS) | −7.99 mmol/L (P=NS) | +0.1 kg/m2 (P=NS) | |
Ju 2016 [22] | (mean) | (mean FPG) | ||||
China | Glargine+SAX (n=60) | 8.9% | −5.2% | −4.4 mmol/L | NR | NR |
RCT | ||||||
13 weeks | Glargine (n=60) | 9.0% | −4.5% | −4.0 mmol/L | ||
Newly diagnosed | (P=NS) | (P<0.05) | ||||
Lee 2012 [23] | (mean) | (mean FPG) | ||||
Korea | Glargine+GLIM 1 | NR | −0.97% | −51.2 mg/dL | 39.6% (overall) | NR |
RCT | mg+MET | 18.8% (nocturnal) | ||||
16 weeks | ||||||
Initiationa | Glargine+GLIM 4 mg (N=97) | −0.22% (P=NR) | −39.8 mg/dL (P=NR) | 41.7% (overall) 18.8% (nocturnal) (both P=NR) | ||
Moon 2014 [24] | (LS mean) | (mean FPG) | (mean weight) | |||
Korea | Glargine+MET (n=38) | 8.8% | −1.8% | −32.6 mg/dL | 26.3% | +1.7 kg |
RCT | ||||||
48 weeks | GLIM+MET (n=34) | 8.9% | −1.8% | −25.2 mg/dL | 55.9% | 0 kg |
Initiationa | (P=NS) | (P=NS) | (overall) (P=0.01) | (P=0.02) | ||
Son 2015 [26] | (mean) | (mean FPG) | (mean weight) | |||
Korea | Glargine+MIT (n=79) | 9.0% | −0.9% | −1.2 mmol/L | 1.3% | +0.93 |
RCT | ||||||
20 weeks | ||||||
Intensification | Glargine+VOG (n=77) | 9.2% | −0.7% MIT noninferior to VOG | −0.9 mmol/L (P=NS) | 4.9% (overall) (P=NS) | +0.01 kg (P<0.01) |
Observational studies
| ||||||
Goto 2007 [29] | Glargine+SU (N=44) | (mean) | (mean weight) | |||
Japan (JUN-LAN4) | HbA1c at 6 months | |||||
Prospective cohort | ≤7% (n=17) | 6.7% | −2.6% | NR | NR | +2.5 kg |
18 Months | >7% (n=27) | 8.2% | −1.7% | +1.7 kg | ||
Initiationa | (both P<0.01 vs Wk 0) | (both P<0.05 vs Wk 0) | ||||
Chien 2014 [28] | Glarginec+OAMs | (mean) | (mean FPG) | (mean weight) | ||
Taiwan | (N=836) | 10.1% | −1.4% | −67.4 mg/dL | 11.4% | +0.7 kg |
Prospective cohort | (P<0.0001 vs Wk 0) | (P<0.0001 vs Wk 0) | (overall) | |||
24 weeks | ||||||
Initiationa | ||||||
Kobayashi 2014 [32] | (mean) | (mean FPG) | (mean weight) | |||
Japan (ALOHA2) | Glargine+OAMs | 9.6% | −1.61% | −54.4 mg/dL | 5.38% (overall) | +0.5 kg |
Prospective cohort | (N=2630) | (P<0.0001 vs Wk 0) | (P<0.0001 vs Wk 0) | 0.54% (nocturnal) | (P<0.0001 vs Wk 0) | |
24 weeks | ||||||
Initiationa | ||||||
Ohta 2014 [34] | Glargine+OAMs (except | (mean) | (mean FPG) | NR | NR | |
Japan | DPP-4i) (N=33) | 8.4% | −1.1% | −59 mg/dL | ||
Prospective cohort | (P<0.01 vs Wk 0) | (P<0.01 vs Wk 0) | ||||
24 Weeks | ||||||
Initiationa | ||||||
Kim 2015 [31] | Glargined+/− OAMs or | (mean) | NR | (mean weight) | ||
Korea | prandial insulin (N=8636) | 9.2% | −1.8% | 17.6% (overall) | +0.3 kg (P=NS vs Wk | |
Prospective cohort | (P<0.0001 vs Wk 0) | 0) | ||||
26 Weeks Initiationa | ||||||
Odawara 2015 [33] | Glargine+OAMs | (mean) | (mean FPG) | (overall) | (mean weight) | |
Japan | No complications (n=1889) | 9.5% | −1.47% | −62.3 mg/mL | 1.0% | 0.8 kg |
Prospective cohort | ret (n=318) | 9.6% | −1.40% | −47.7 mg/mL | 0.3% | 0.9 kg |
24 weeks | neur (n=297) | 9.6% | −1.52% | −64.2 mg/mL | 2.0% | 1.3 kg |
Initiationa | neph (n=356) | 9.5% | −1.42% | −71.1 mg/mL | 0.6% | 1.2 kg |
ret+neur (n=174) | 9.6% | −1.38% | −67.0 mg/mL | 0.6% | 0.9 kg | |
ret+neph (n=154) | 9.6% | −1.38% | −63.3 mg/mL | 3.2% | 1.1 kg | |
neur+neph (n=142) | 9.7% | −1.59% | −86.5 mg/mL | 0% | 0.8 kg | |
ret+neur+neph (n=301) | 9.7% | −1.45% | −55.0 mg/mL | 1.7% | 0.8 kg | |
Tsukube 2016 [37] | (mean) | (overall) | ||||
Japan (ALOHA2) | Glargine+SU (n=122) | 9.4% | −0.96% | NR | 3.3% | NR |
Prospective cohort | +DPP-4i (n=104) | 9.7% | −2.46% | 1.9% | ||
24 weeks | +BG (n=58) | 10.4% | −2.76% | 5.2% | ||
Initiationa | +SU+DPP−4i (n=143) | 9.3% | −1.40% | 6.3% | ||
+BG+DPP−4i (n=49) | 9.8% | −1.34% | 4.1% | |||
+BG+SU (n=112) | 9.7% | −1.31% | 3.6% | |||
+BG+SU+DPP−4i (n=156) | 9.5% | −1.34% | 3.9% | |||
(all P<0.05 vs baseline; between groups, P=NR) | (between groups, P=NS) | |||||
Suzuki 2012 [36] | (mean) | (mean weight) | ||||
Japan | Glargine+OAMs (N=57) | 8.6% | −1.4% | NR | NR | −0.7 kg |
Retrospective cohort | (P<0.05 vs Wk 0) | (P=NS vs Wk 0) | ||||
52 weeks | Improvement significantly greater in patients on insulin- secreting OAMs | |||||
Initiationa | ||||||
Chien 2015 [27] | Glargine+OAMs | (mean) | (mean FPG) | (overall) | (mean weight) | |
Taiwan | Age ≥65 (n=32) | 9.8% | −1.18% | −81.0 mg/dL | 9.4% | +1.3 kg |
24 weeks | Age <65 (n=40) | 10.3% | −1.5% | −93.0 mg/dL | 15.0% | +1.9 kg |
Initiationa | (P=NS)(both P<0.001 vs Wk 0) | (P=NS)(both P<0.001 vs Wk 0) | (P=NS) | |||
Okayama 2009 [35] | Glargine+SU+ | (mean) | (mean weight) | |||
Japan (JUN-LAN7) | prandial insulin (N=16) | 8.1% | −0.9% | NR | NR | +1.9 kg |
Prospective cohort | (P<0.0001 vs Wk 0) | |||||
24 weeks | ||||||
Intensificationb | ||||||
Ji 2017 [30] | Glargine+OAMs | (mean) | (mean FPG) | (minor) | (mean weight) | |
China (ORBIT) | (N=11290) | 9.6% | −2.17% | −3.82 | 7.2% | +0.09 |
Prospective cohort | Detemir+OAMs | |||||
26 weeks | (N=2135) | 9.6% | −2.19% | −4.00 | 10.4% | −0.06 |
Initiationa | NPH+OAMs (N=2916) | 9.6% | −2.03% (P<0.0014, glargine vs NPH) | −3.43 mmol/L (P<0.0005, glargine vs NPH; P<.0002, detemir vs NPH) | 12.8% (P<0.0001, glargine vs detemir; P<0.0001, glargine vs NPH; P=0.0131, detemir vs NPH) | +0.28 kg (P=0.032, glargine vs detemir; P<0.0032, glargine vs NPH; P<0.0001, detemir vs NPH) |
Biguanides
Sulfonylureas
Dipeptidyl Peptidase-4 Inhibitors
Glinides and α-Glucosidase Inhibitors
Insulin Glargine vs Other Injectable Treatments in Patients with Type 2 Diabetes Mellitus
IGlar vs NPH
Author year Country Design Duration Initiation/intensificationa | Treatment Group(s) | Baseline HbA1c | HbA1c Change | FBG/FPG Change | Hypoglycemia | Body Weight/BMI Change |
---|---|---|---|---|---|---|
Glargine vs NPH
| ||||||
Kawamori 2003 [53] | (mean) | (mean FPG) | (mean weight) | |||
Japan | Glargine+OAMs | 9.07% | −1.10% | −46.29 mg/dL | 39.0% (overall) | +1.69 kg |
RCT | (n=167) | 5.0% (nocturnal) | ||||
28 Weeks | +1.46 kg | |||||
Initiationa | NPH+OAMs (n=168) | 9.11% | −1.05%(P=NS) | −27.91 mg/dL(P=0.0052) | 41.0% (overall) 2.2% (nocturnal) (P=NS for overall and nocturnal) | (P=NS) |
Wang 2007 [54] | (mean) | (mean FBG) | (mean weight) | |||
China | Glargine (n=16) | 8.8% | −1.15% | −4.52 mmol/L | 12.5% (overall) | +1.47 kg |
RCT | 6.3% (nocturnal) | |||||
12 weeks | NPH (n=8) | 8.8% | −1.32% | −4.56 mmol/L | 50% (overall) | +1.20 kg |
Initiationa | (P=NS) | (P=NS) Glargine associated with significantly less fluctuation in BG profiles | 50% (nocturnal) (P=NS, overall) (P=0.028, nocturnal) | (P=NS) | ||
Glargine vs premixed insulin
| ||||||
Tamemoto 2007 [66] | (mean) | (mean FPG) | (mean BMI) | |||
Japan | Glargine (n=19) | 8.5% | −0.95% | −48.1 mg/dL | 54.5% (overall) | 0.1 kg/m2 |
RCT | 18.2% (nocturnal) | |||||
26 weeks | ||||||
Initiationa | BIAsp30 2X daily (n=11) Both +OAMs, except SU in BIAsp30 group | 9.1% | −1.2% (P=NS) | −41.9 mg/dL (P=NS) | 80.0% (overall) 60.0% (nocturnal)(P=NR overall) (P=NS nocturnal) | 0.2 kg/m2(P=NS) |
Feng 2009 [62] | (overall) | (BMI) | ||||
Chinese | Glargine+ACA (n=42) | NR | Significantly decreased in both groups | NR | 4.8% | No change |
RCT | 73.8% | increased | ||||
8 weeks | 3X daily 30% neutral insulin and 70% NPH+ACA (n=42) | (P<0.05) | ||||
Initiationa | ||||||
Onishi 2013 [64] | (mean) | (mean FPG) | (mean weight) | |||
Japan | Glargine (n=149) | 8.5% | −1.2% | −3.5 mmol/L | 44.3% (overall) | +0.7 kg |
RCT | 16.1% (nocturnal) | |||||
26 weeks | ||||||
Initiationa | 1X daily IDegAsp (n=147) Both +OAMs except SU, DPP-4i, glinides | 8.3% | −1.4%(P<0.01) IDegAsp superior to glargine | −3.3 mmol/L(P=NS) | 44.2% (overall) 8.2% (nocturnal)(P=NS) | +0.7 kg(P=NS) |
Yang 2013 [67] | (mean) | (mean weight) | ||||
China, Japan | Glargine (n=260) | 8.1% | −0.65% | NR | 56.9% (overall) | +1.4 kg |
RCT | 15.0% (nocturnal) | |||||
24 weeks | 1X daily BIAsp30 | 8.2% | −0.78% | 59.4% (overall) | +1.2 kg | |
Initiationa | (n=261) Both +MET, GLIM | BIAsp30 noninferior to glargine | 18.8% (nocturnal) (Both P=NR) | (P=NS) | ||
Sun 2014 [65] | (mean) | (mean FBG) | (overall) | (mean BMI) | ||
China | Glargine+ACA (n=94) | 8.6% | −1.39 | −1.75 mmol/L | 7 patients | 0.5 kg/m2 |
RCT | ||||||
32 weeks | 2X daily 30% neutral insulin and 70% NPH (n=94) | 8.7% | −1.54 | −1.94 mmol/L | 11 patients | 0.6 kg/m2 |
Initiationa | (P=NR) | (P=NR) | (P=NR) | |||
Ji 2016 [63] | (LS mean) | (mean weight) | ||||
China, Korea | Glargine+1-3X daily | 8.8% | −1.76% | NR | 77.3% (overall) | +2.81 kg |
RCT | prandial insulin (n=44) | 52.3% (nocturnal) | ||||
48 weeks | ||||||
Initiationa | 1-3X daily LM25 (n=45) Both +OAMs | 8.9% | −2.03% (P=NR) | 69.8% (overall) 41.9% (nocturnal) (Both P=NR) | +2.95 kg (P=NR) | |
Jia 2015 [69] | (LS mean) | (mean weight) | ||||
China, Korea, Taiwan | Glargine+3X daily | 8.7% | −1.1% | NR | 55% (overall) | +0.7 |
RCT | prandial insulin (n=202) | 11% (nocturnal) | ||||
24 weeks | ||||||
Intensificationb | 3X daily LM50+LM25 (n=197) Both +OAMs | 8.6% | −1.1% LM50 + LM25 noninferior to glargine | 55% (overall) 14% (nocturnal) (Both P=NR) | +0.8 kg(P=NR) | |
Jeong 2017 [68] | (mean) | (mean FBG) | (mean weight) | |||
China, Korea | Glargine+1X daily | 8.7% | −0.9% | −0.25 mmol/L | 82% (overall) | +0.51 kg |
RCT | prandial insulin (n=40) | 18% (nocturnal) | ||||
24 weeks | ||||||
Intensificationb | 2X daily LM25 (n=40) Both +MET and/or PIO | 8.8% | −1.3% (P<0.001) | −0.40 mmol/L(P=NS) | 65% (overall) 18% (nocturnal) (Both P=NR) | +0.62 kg (P=NR) |
Jin 2016 [70] | (mean) | (mean FPG) | (Glargine vs BIAsp) | (mean weight) | ||
Korea | Glargine+insulin | 8.3% | −0.91% | 3.1 |
Baseline-Wk 12
| 1.22 kg |
RCT | glulisine (n=78) | 88.5% vs 68.3% | ||||
24 weeks | (overall) (P=0.002) | |||||
Intensificationb | 2X daily BIAsp30 (n=82) Both +OAMs | 8.5% | −1.07% (P=NS) BIAsp30 noninferior to glargine | 24.4 mg/dL (P<0.001) | 34.6% vs 23.2% (nocturnal) (P=NS)
Wk 12-24
69.2% vs 72.0% (overall) (P=0.230) 25.6% vs 30.5% (nocturnal) (P=NS) | +1.05 kg (P=NS) |
Glargine vs newer basal insulin analogs
| ||||||
Osonoi 2016 [76] | (mean) | (mean weight) | ||||
Japan | Glargine (n=44) | 8.4% | −1.63% | NR | 61.4% (overall) | +1.75 kg |
RCT | 22.7% (nocturnal) | |||||
26 weeks | IDeg (n=89) | 8.6% | −1.52% | 53.4% (overall) | +1.65 kg | |
Initiationa | Both +OAMs, except DPP-4i | (P=NS) | 17.0% (nocturnal) (Both P=NR) | (P=NR) | ||
Terauchi 2016 [75] | (LS mean) | (LS mean FPG) | (LS mean weight) | |||
Japan | Glargine U100 | 8.1% | −0.55% | −1.25 | 80.0% (overall) | +0.4 kg |
RCT | (n=120) | 47.5% (nocturnal) | ||||
26 weeks | ||||||
Intensificationb | glargine U300 (n=121) Both +OAMs | 8.0% | −0.45% (P=NS)U300 noninferior to U100 | −1.21 mmol/L(P=NS) | 70.8% (overall) 30.8% (nocturnal)(Both P=NR) | −0.6 kg(P<0.001) |
Glargine vs GLP-1RAs
| ||||||
Inagaki 2012 [85] | (LS mean) | (LS mean FSG) | (LS mean weight) | |||
Japan | Glargine (n=212) | 8.5% | −0.68% | −46 mg/dL | 20.8% (overall) | +0.34 kg |
RCT | 10.4% (nocturnal) | |||||
26 weeks | ||||||
Initiationa | Exenatide (n=215) Both +OAMs | 8.5% | −1.11% (P<0.001) Exenatide noninferior to glargine | −41 mg/dL(P=NS) | 9.8% (overall) 0.9% (nocturnal)(Both P<0.01) | −1.67 kg(P<0.001) |
Araki 2015 [84] | (LS mean) | (LS mean FSG) | (LS mean weight) | |||
Japan | Glargine (n=180) | 8.0% | −0.90% | −2.1 mmol/L | 48% (overall) | +0.94 kg |
RCT26 weeks | 27% (nocturnal) | |||||
Initiationa | Dulaglutide (n=181) Both +OAMs | 8.1% | −1.44% (P<0.001) Dulaglutide noninferior and superior to glargine | −1.9 mmol/L (P=NS) | 26% (overall) 9% (nocturnal) (Both P<0.001) | −0.48 kg (P<0.001) |
Seino 2012 [86] | (LS mean) | (LS mean FPG) | (overall) | (LS mean weight) | ||
Japan, Korea, Taiwan, | Basal | 8.5% | −0.77% | −0.42 mmol/L | 42.9% | −0.38 kg |
Philippinesc | insulind+lixisenatide | |||||
RCT | (n=154) | |||||
24 weeks | ||||||
Intensificationb | Basal insulind (n=157) Both ±SU | 8.5% | +0.11% (P<0.001) | +0.25 mmol/L (P=0.0187) | 23.6% | +0.06 kg (P=NS) |
Seino 2016 [87] | (mean) | (mean FPG) | (mean weight) | |||
Japan | Insuline+liraglutide | 8.8% | −1.73% | −1.3 mmol/L | 33.1% (overallf) | −0.42 kg |
RCT | (n=127) | 4.7% (nocturnalf) | ||||
16 weeks | ||||||
Intensificationb | Insuline (n=130) | 8.8% | −0.43% (P<0.0001) | −0.5 mmol/L (P=0.0006) | 27.7% (overallf) 8.5% (nocturnalf) | −0.28 kg (P=NS) |
IGlar vs Premixed Insulin
IGlar vs Newer Basal Insulin Analogs
IGlar vs/+ Glucagon-Like Peptide-1 Receptor Agonists
Switching to Insulin Glargine from Other Diabetes Therapies
Author year Country Design Duration | Treatment Group(s) | Baseline HbA1c | HbA1c Change | FBG/FPG Change | Hypoglycemia | Body Weight/BMI Change |
---|---|---|---|---|---|---|
Switch from NPH
| ||||||
Yokoyama 2006 [91] | (mean) | (mean FBG) | (overall) | (mean BMI) | ||
Japan | Glargine (switched from NPH) (n=31) | 7.2% | −0.6% | −2.1 mmol/L | 48% | +0.5 kg/m2 |
RCT | ||||||
26 weeks | NPH (n=31) Both +prandial insulin | 6.9% | +0.1% (P=0.007) | −1.0 mmol/L (P<0.01) | 42% (P=NS) | −0.6 kg/m2 (P=NS) |
Suzuki 2012 [90] | (mean) | (mean FBG) | (mean weight) | |||
Japan | Glargine+prandial | 8.0% | −0.4% | −41.8 mg/dL | 1 patient had severe hypoglycemia | +0.9 kg |
Prospective cohort | insulin (N=400) | |||||
52 weeks | Switched from NPH+prandial insulin | (P<0.05 vs Wk 0) | (P<0.05 vs Wk 0) | |||
Kanazawa 2007 [89] | (mean) | (mean FPG) |
Episodes/month
| |||
Japan | Glargine+prandial insulin (N=46) | 8.2% | −0.5% | −23.5 mg/dL | Wk 0: 3.43 | Mean weight |
Prospective cohort | Wk 78: 1.66 | Slight, but significant | ||||
78 weeks | Switched from NPH+prandial insulin | (P<0.05 vs Wk 0) | (P<0.01 vs Wk 0) | (P=NS) | (P<0.01) increase vs Wk 0 | |
Switch from premixed insulin
| ||||||
Bu 2007 [92] | (mean) | (overall) | ||||
China | Glargine (switched from 2X daily premixed) | 7.0−10.0% | −0.8% | NR | 47% | NR |
RCT | ||||||
12 weeks | 2X daily premixed 30R insulin (70/30) (N=80) Both +GLIM | −1.1% (P=NS) | 76% (P<0.01) | |||
Takahashi 2015 [94] | Glargine at 80% of | 7.7% | Mean | (Mean FPG) | NR | NR |
Japan | premixed dose (n=23) | −0.6% | −37.6 mg/dL | |||
RCT | ||||||
24 weeks | Glargine at 50% premixed dose+SITA (n=21) Switched from 2X daily premixed insulin | 7.4% | 0% | 17.1 mg/dL | ||
Shigihara 2010 [93] | (mean) | (mean) | (overall) | (mean weight) | ||
Japan | Glargine+SU (N=21) | 8.3% | −0.6% | −34.5 mg/dL | 23.8% | 0.7 kg |
Prospective cohort | ||||||
24 weeks | Switched from 2X premixed insulin | (P<0.05 vs Wk 0) | ||||
Yang 2012 [96] | (mean) | (mean FPG) | (mean weight) | |||
China | Glargine+OAMs | 8.4% | −0.51% | −2.92 mg/dL | NR | 0.06 kg |
Prospective cohort | (N=297) | |||||
16 weeks | Switched from premixed insulin | (P<0.001 vs Wk 0) | (P<0.001 vs Wk 0) | (P=NS) | ||
Zhang 2014 [98] | (mean) | (mean FBG) | (mean weight) | |||
China | Glargine+OAMs | 8.3% | −1.45% | 2.07 mmol/L | 2 patients reported | −1.1 kg |
Prospective cohort | (N=70) | symptomatic | ||||
20 weeks | Switched from premixed insulin | (P<0.001) | (P<0.001) | hypoglycemia | (P=NS) | |
Zhang 2017 [97] | (mean) | (mean FPG) | (mean weight) | |||
China | Glargine+OAMs | 7.8% | −0.8% | −1.4 mmol/L | 15.5% (overall) | −0.2 kg |
Prospective cohort | (N=1847) | (P<0.0001 vs Wk 0) | (P<0.0001 vs Wk 0) | 1.1% (nocturnal) | (P<0.0001 vs Wk 0) | |
16 weeks | Switched from premixed insulin+OAMs | |||||
Umezono 2013 [95] | (mean) | (mean FBG) | (mean BMI) | |||
Japan | Glargine+OAMs | 7.6% | −0.7% | −29.4 mg/dL | NR | No change |
Retrospective cohort | (N=20) | |||||
156 weeks | Switched from 2X daily premixed insulin | (P<0.05) | (P=NS) | |||
Switch from other treatments
| ||||||
Taniguchi 2015 [100] | (mean) | (mean FPG) | (mean weight) | |||
Japan | Glargine (N=98) | 8.84% | −0.86% | −44.6 mg/dL | 67.4% (overall) | +3.76 kg |
Prospective cohort | 19.1% (nocturnal) | (P<0.0001 vs Wk 0) | ||||
24 weeks | Switched from GLP-1RA | (P<0.0001 vs Wk 0) | (P<0.0001 vs Wk 0) | |||
Takahara 2012 [99] | (mean) | (mean BG) | ||||
Japan | Glargine+SITA+tapered/withdrawn GLIM (N=22) | 7.4% | No change from baseline (P=NS) | −0.2 mmol/L (P=NS) | No change in overall incidence; severe incidence reduced | NR |
Retrospective cohort | ||||||
2 months | Switched from Glargine+GLIM | BG fluctuation significantly decreased from baseline |
Real-World Use of Insulin Glargine in East Asians
Insulin Glargine 100 U/mL: Recommendations
Initiation: Guidelines and Timing
Recommendation | China [112] | Korea [111] | Taiwan [109] | |
---|---|---|---|---|
HbA1c target | < 7% | < 6% for normoglycemia < 7% to prevent complications < 8% when intensification of therapy is considered difficult | < 6.5% | < 7%, with individual considerations Goal in older adults (≥ 65 years) is based on number of chronic illnesses, cognitive status, and instrumental activities of daily living (healthy < 7.5%, intermediate health < 8.0%, poor health < 8.5%) |
Insulin initiation | Basal or premixed once/twice daily Combination with OAMs | May be given as initial therapy with lifestyle modifications Should be given to patients not meeting glycemic goals with OAMs Combination with OAMs | Basal, twice-daily premixed, or multiple injections (depending on patient’s condition) Combination OAMs or GLP-1 agonist | May be given as initial therapy with lifestyle modifications if HbA1c ≥ 8.5% Should be given to patients not achieving glycemic goals with OAMs Combination with OAMs |