Glycaemic responses in Asian and non-Asian people with type 2 diabetes initiating insulin glargine 100 units/mL: A patient-level pooled analysis of 16 randomised controlled trials. (January 2018)

• Record Type: Journal Article
• Authors: Chan, Juliana C.N.; Bunnag, Pongamorn; Chan, Siew P.; Tan, Iris T.I.; Tsai, Shih-Tzer; Gao, Ling; Landgraf, Wolfgang
• Is Part Of: Diabetes research and clinical practice. Volume 135(2018)
• Page Start: 199
• Page End: 205
• Publication Date: 2018-01
• Subjects: Type 2 diabetes -- Asian -- Insulin glargine -- Meta-analysis; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2017.11.025
• Languages: English
• ISSNs: 0168-8227

Abstract

Highlights: Asian patients with T2D in our cohort had lower BMI and C-peptide than non-Asians. Asian patients had lower, FPG and starting insulin dose (U/day). Gla-100 effectively lowers HbA1c and FPG in both Asian and non-Asian patients. Asian patients may benefit from alternative intensification strategy. Abstract: Aims: To compare outcomes between Asian and non-Asian patients with type 2 diabetes (T2D) inadequately controlled on oral antidiabetic drugs (OADs) initiating insulin glargine 100 units (U)/mL (Gla-100) in randomised controlled clinical trials. Methods: Post hoc analysis of patient-level data (Asian n = 235; non-Asian n = 3351) from 16 trials. Results: At baseline, Asian patients were younger with lower body mass index (BMI), fasting C-peptide, and fasting plasma glucose (FPG) than non-Asian patients (all P < .001). Asian patients had a higher mean glycosylated haemoglobin (HbA1c) at Week 24 and less reduction in HbA1c from baseline (7.4% vs. 7.2%; −1.3% vs. −1.6%, respectively; P = .0001), and were less likely to achieve HbA1c <7.0% (40% vs. 47%; P = .002) than non-Asian patients. Reductions in FPG and rates of hypoglycaemia were similar between Asian and non-Asian patients. Asian patients had less weight gain than non-Asian patients (+1.3 vs. +1.9 kg, respectively, P = .013). Conclusions: In our post hoc meta-analysis, Gla-100 effectively lowers HbA1c and FPG in Asian patients with T2D uncontrolled on OADs with similar incidence of hypoglycaemia and less absolute weight gain compared with non-Asian patients. At a similar FPG reduction, fewer Asian patients achieved HbA1c target <7.0%, suggesting that prandial glucose needs to be addressed.