The experience of insulin Glargin 300 U/ml (Toujeo) use in an emergency city hospital

• Evgeniya Yu. Pashkova
• Irina V. Gosnevskaya
• Beliaeva Elina N.

Abstract

This review is devoted to the evaluation of the effectiveness and safety of the innovative long-acting insulin analog Glargine 300 U/ml in real clinical practice. The relevance of the use of basal insulins with low variability of action is beyond doubt. In a series of studies, insulin glargine 300 U/ml demonstrated a duration of action exceeding 24 h, a lower risk of hypoglycemk episodes, and a similar decrease in HbA_1c levels compared to insulin Glargine 100 U/ml. In the BRIGHT study, insulin Glargine 300 U/ml compared to insulin Degludek, showed а significantly lower incidence of hypoglycemia during 12 week titration period, as well as a comparably low incidence of nocturnal hypoglycemia, which is extremely important in the management of patients at high risk of hypoglycemia. Insulin Glargine 300 U/ml, administered to patients who underwent pancreatic surgery proved to be an optimal basal insulin according to the experience of the endocrinology department of Botkin City Hospital. It contributed to more stable glycemic control and had a positive impact on the long-term control of diabetes. So, the conclusion is that insulin Glargine 300 U/ml is a further step to a more physiological insulin therapy, and its widespread implementation gives new opportunities in the control of diabetes.

Keywords:insulin Glargin, basal insulin, hypoglycemia, night hypoglycemia, glucose variability, glycemic control

References

1. IDF Diabetes Atlas. 8^th ed. 2017. URL: https://www.idf.org/e-library/epidemiology-research/diabetes-atlas/134-idf-diabetes-atlas-8th-edition.html

2. Standards of specialized diabetes care. Edited by Dedov I.I., Shestakova M.V., Mayorov A.Yu. 9^th ed. Sakharni Diabet [Diabetes Mellitus]. 2019; 22 (S1). doi: 10.14341/DM221S1 (in Russian)

3. Antsiferov M.B., Demidov N.A., Kalashnikova M.F. Dynamics of the main epidemiological indicators of diabetes in Moscow (2002-2017) // Diabetes-pandemic XXI: collection of abstracts VIII (XXV) all-Russian dia-betological Congress with international participation. Russian Association of endocrinologists. Moscow: UP PRINT; 2018. (in Russian)

4. Demidov N.A., Mishra O.M., Antsiferov M.B. Type 1 diabetes mellitus in Moscow-2018 (according to the Moscow segment of the Federal register of diabetes mellitus). Farmateka [Pharmateca]. 2018; 11 (364): 74-9. doi: 10.18565/pharmateca. 2018. 11.74-78 (in Russian)

5. Antsiferov M.B. Glycemic control in patients with type 2 diabetes mellitus during initiation of insulin therapy in real clinical practice of the Russian Federation: results of the study CREDIT. Farmateka [Pharmateca]. 2009; (17): 70-2. (in Russian)

6. Demidov N.A., Mishra O.A., Safronova T.I., Antsiferov M.B. Initiation of insulin therapy in patients with type 2 diabetes mellitus according to the Federal Diabetes Register in Moscow. Farmateka [Pharmateca]. 2018; 11 (364):.60-5. doi: 10.18565/pharmateca.2018.11.60-64 (in Russian)

7. Hilgenfeld R., Seipke G., Berchtold H., Owens D.R. The Evolution of insulin glargine and its continuing contribution to diabetes care. Drugs. 2014; 74 (8): 911-27. doi: 10.1007/s40265-014-0226-4.

8. Rosskamp R.H., Park G. Long-acting insulin analogs. Diabetes Care. 1999; 22 (suppl 2): 109-13. PMID: 10097910

9. Heinemann L., Linkeschova R., Rave K., Hompesch B., et al. Time-action profile of the long-acting insulin analog insulin glargine (HOE901) in comparison with those of NPH insulin and placebo. Diabetes Care. 2000; 23 (5): 644-9. doi: 10.2337/diacare.23.5.644

10. Bolli G.B., Songini M., Trovati M., Del Prato S., et al. Lower fasting blood glucose, glucose variability and nocturnal hypoglycaemia with glargine vs NPH basal insulin in subjects with type 1 diabetes. Nutr Metab Cardiovasc Dis. 2009; 19 (8): 571-9. doi: 10.1016/j.numecd.2008.05.00

11. Pan C.Y., Sinnassamy P., Chung K.D., Kim K.W. Insulin glargine versus NPH insulin therapy in Asian type 2 diabetes patients. Diabetes Res Clin Pract. 2007; 76 (1): 111-8.

12. HOE 901/2004 Study Investigators Group. Safety and efficacy of insulin glargine (HOE 901) versus NPH insulin in combination with oral treatment in type 2 diabetic patients. Diabet. Med. 2003; 20 (7): 545-51. doi: 10.1046/j.1464-5491.2003.00999.x

13. Becker R.H., Dahmen R., Bergmann K., et al. New insulin glargine 300 units/mL provides a more even activity profile and prolonged glycemic control at steady state compared with insulin glargine 100 units/mL. Diabetes Care. 2015; 38: 637-43.

14. Riddle M.C., Bolli G.B., Ziemen M., et al.; EDITION 1 Study Investigators. New insulin glargine 300 units/mL versus glargine 100 units/mL in people with type 2 diabetes using basal and mealtime insulin: glucose control and hypoglycemia in a 6-month randomized controlled trial (EDITION 1). Diabetes Care. 2014; 37: 2755-62. doi: 10.2337/dc14-0991

15. Yki-Jarvinen H., Bergenstal R., Ziemen M., et al.; EDITION 2 Study Investigators. New insulin glargine 300 units/mL versus glargine 100 units/mL in people with type 2 diabetes using oral agents andbasal insulin: glucose control and hypoglycemia in a 6-month randomized controlled trial (EDITION 2). Diabetes Care. 2014; 37: 3235-43. doi: 10.2337/dc14-0990

16. Bolli G.B., Riddle M.C., Bergenstal R.M., et al.; on behalf of the EDITION 3 study investigators. New insulin glargine 300 U/mL compared with glargine 100 U/mL in insulin-naive people with type 2 diabetes on oral glucose-lowering drugs: a randomized controlled trial (EDITION 3). Diabetes Obes Metab. 2015; 17: 386-94. doi: 10.1111/dom.12438

17. Home P.D., Bergenstal R.M., Bolli G.B., et al. New insulin glargine 300 units/mL versus glargine 100 units/mL in people with type 1 diabetes: a randomized, phase 3a, open-label clinical trial (EDITION 4). Diabetes Care. 2015; 38: 2217-25.

18. Demidov N.A., Antsiferov M.B. Moscow experience of application of a new long-acting insulin analogue. Farmateka [Pharmateca]. 2018; 4 (357): 28-31.

19. Cheng A., et al. T2DM Management: What Is the Evidence for Second-Generation Insulins? URL: https://www.medscape.org/view-article/894132_2 (date of access July 4, 2018) (in Russian)

All articles in our journal are distributed under the Creative Commons Attribution 4.0 International License (CC BY 4.0 license)