Early Insulin Glargine Addition to Metformin for Better Diabetes Control
Author Information
Author(s): Fonseca V, Gill J, Zhou R, Leahy J
Primary Institution: Tulane University Medical Center
Hypothesis
Does initiating insulin glargine earlier in treatment improve glycaemic control and reduce hypoglycaemia in patients with type 2 diabetes?
Conclusion
Adding insulin glargine to metformin monotherapy early in treatment may provide better efficacy and safety compared to regimens including sulfonylurea.
Supporting Evidence
- Patients on 0/1 OAD had the largest reductions in HbA1c after adding insulin glargine.
- 68.1% of patients on MET alone achieved HbA1c ≤ 7.0%.
- Patients on MET alone had less hypoglycaemia than those on SU or MET + SU.
Takeaway
Starting insulin earlier can help people with diabetes control their blood sugar better and have fewer low blood sugar episodes.
Methodology
Pooled analysis of 11 randomized clinical trials with 2171 adults with uncontrolled type 2 diabetes initiating insulin glargine.
Potential Biases
Potential biases related to the selection of studies and the focus on insulin glargine only.
Limitations
Only studies of insulin glargine were evaluated; applicability to other insulin formulations is unknown.
Participant Demographics
Mean age 58.6 years, 55.6% male, 88.3% White.
Statistical Information
P-Value
p = 0.0006
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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