Efficacy and safety of insulin glargine compared to other interventions in younger and older adults: a pooled analysis of nine open-label, randomized controlled trials in patients with type 2 diabetes.

Abstract

OBJECTIVE:

Elderly patients with type 2 diabetes mellitus (T2DM) present therapeutic challenges related to co-morbidities, treatment adherence, and safety. This study examines the efficacy and safety of insulin glargine compared to other glucose-lowering interventions in younger and older adults.

METHODS:

In this pooled analysis of 24-week data from nine prospective open-label, multicenter, phase 3/4, two-arm, parallel-group, randomized controlled trials, patients with T2DM aged 18-80 years received insulin glargine (used as a basal insulin regimen) or comparators (including rosiglitazone, pioglitazone, insulin lispro, insulin lispro 75/25, NPH insulin, NPH insulin 30/70, and lifestyle/dietary measures). Endpoints included change from baseline to week 24 in: glycated hemoglobin; fasting plasma glucose; body weight; body mass index; insulin dose; incidence of nocturnal, daytime, or any hypoglycemia. Results were stratified by age (<65, ≥65, 65-74, and ≥75 years) and treatment (insulin glargine or comparator).

RESULTS:

A total of 2,938 patients were included (2,263 aged <65 years, 675 aged ≥65 years). Similar levels of glycemic control were achieved in both younger (<65 years) and older (≥65 years) patients with T2DM. Insulin glargine was associated with better glycemic control and a reduced incidence of daytime and any hypoglycemia versus comparator interventions in both younger and older T2DM patients.

CONCLUSION:

This analysis suggests that insulin glargine may represent a safe option to improve glycemic control in older patients with T2DM.

• Authors: Naushira Pandya, Andres DiGenio, Ling Gao, Meenakshi Patel
• Journal: Drugs & aging (Drugs Aging) Vol. 30 Issue 6 Pg. 429-38 (Jun 2013) ISSN: 1179-1969 [Electronic] New Zealand
• PMID: 23539233 (Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't)

Chemical References

• Blood Glucose
• Insulin
• Insulin, Long-Acting
• Insulin Glargine

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Blood Glucose (drug effects)
• Body Mass Index
• Body Weight
• Clinical Trials, Phase III as Topic
• Clinical Trials, Phase IV as Topic
• Diabetes Mellitus, Type 2 (drug therapy)
• Drug Administration Schedule
• Humans
• Insulin (metabolism)
• Insulin Glargine
• Insulin, Long-Acting (therapeutic use)
• Middle Aged
• Multicenter Studies as Topic
• Prospective Studies
• Randomized Controlled Trials as Topic
• Treatment Outcome
• Young Adult