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Basal insulin peglispro may improve glycemic control in type 2 diabetes
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Greater glycemic control was found with basal insulin peglispro therapy compared with Lantus among patients with type 2 diabetes previously treated with basal insulin, according to recent study findings published in Diabetes Care.
Basal insulin peglispro (Eli Lilly) also reduced nocturnal and total hypoglycemia, lowered glucose variability, and increased triglycerides and aminotransferases, according to researchers.
John B. Buse
John B. Buse , MD, PhD, of the University of North Carolina School of Medicine in Chapel Hill, and colleagues conducted a 52-week, open-label, treat-to-target study that randomly assigned adults with type 2 diabetes (mean HbA1c, 7.42%) to basal insulin peglispro (n = 307) or Lantus (glargine, Sanofi; n = 159) to determine the safety and efficacy of each treatment.
At weeks 26 and 52, HbA1c of less than 7% was reached by more of the basal insulin peglispro group compared with the glargine group (P < .001 for both). Nocturnal hypoglycemia rate was 60% lower with basal insulin peglispro. HbA1c of less than 7% without nocturnal hypoglycemia was reached by more of the basal insulin peglispro group compared with the glargine group at 26 and 52 weeks (P < .001). At 52 weeks, total hypoglycemic rates were lower among the basal insulin peglispro group compared with the glargine group (P = .03).
Compared with glargine, basal insulin peglispro yielded lower glucose variability (P < .01); basal insulin dose was greater (P < .001) and triglyceride and aminotransferase levels were higher (P < .05) at weeks 26 and 52.
“This 52-week, treat-to-target study in patients with type 2 diabetes previously treated with basal insulin demonstrates that switching to [basal insulin peglispro] provides superior glycemic efficacy with clinically significant reductions in HbA1c with lower risk of nocturnal and total hypoglycemia and lower glucose variability,” the researchers wrote. “Increases were seen in aminotransferases, triglycerides and [liver fat content] in comparison with glargine. The conversion from a conventionally acting basal insulin to [basal insulin peglispro], a hepato-preferential insulin with reduced peripheral action, may account for these findings.” – by Amber Cox
Disclosure: The study was funded by Eli Lilly and Company. Buse reports being a consultant/investigator for Eli Lilly and reports various relationships with several pharmaceutical companies. Please see the full study for a list of all other authors’ relevant financial disclosures.
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