Target attainment in insulin-naive patients at high risk for hypoglycemia: Results from ACHIEVE Control
John Anderson, Luigi Meneghini, Debbie Hinnen, Jasvinder Gill, Mathieu Coudert, Pierre Evenou, Medha Munshi, John Anderson, Luigi Meneghini, Debbie Hinnen, Jasvinder Gill, Mathieu Coudert, Pierre Evenou, Medha Munshi
Abstract
Aims: To better understand outcomes in people with type 2 diabetes at high risk of hypoglycemia, we conducted post hoc analyses in subgroups of participants from the real-world ACHIEVE Control study (NCT02451137) with ≥1 hypoglycemia risk factor.
Methods: Insulin-naive adults with type 2 diabetes and A1c ≥8% were randomized 1:1 to insulin glargine 300 U/mL (Gla-300) or standard-of-care basal insulin (SOC-BI). Participants had documented history of ≥1 risk factors for hypoglycemia: chronic kidney disease, cardiovascular disease, dementia or blindness, age ≥65 years, or history of hypoglycemia. Outcomes included individualized A1c target attainment without documented symptomatic hypoglycemia (blood glucose [BG] ≤3.9 mmol/L or <3.0 mmol/L) or severe hypoglycemia, A1c target attainment, and absence of documented symptomatic or severe hypoglycemia at 6 and 12 months.
Results: Within subgroups, odds ratios generally showed trends favoring Gla-300 versus SOC-BI, particularly for hypoglycemia avoidance in participants ≥65 years of age (BG ≤3.9 mmol/L; odds ratio, 1.52; 95% confidence interval, 1.14-2.03) and those with chronic kidney disease (BG ≤3.9 mmol/L; odds ratio, 2.28; 95% confidence interval, 1.26-4.12). Results were consistent with the overall population.
Conclusions: These data suggest potential benefit of Gla-300 versus SOC-BI for avoiding hypoglycemia in participants with ≥1 hypoglycemia risk factor.
Keywords: Basal insulin; Hypoglycemia; Insulin glargine; Risk factors; Type 2 diabetes.
Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.
Source: PubMed