No difference in hypoglycemia duration with insulin icodec vs insulin glargine in type 2 diabetes
medwireNews: People with type 2 diabetes receiving the once-weekly basal insulin analog insulin icodec have similar hypoglycemic episode durations to those given insulin glargine, regardless of titration algorithm, initial loading dose, or prior insulin use, study findings indicate.
Robert Silver (Southern New Hampshire Diabetes and Endocrinology, Nashua, USA) presented the results of a post-hoc data analysis from two 16-week randomized, phase 2, treat-to-target trials at the virtual 57th EASD Annual Meeting.
In the first trial, which compared three icodec titration algorithms with insulin glargine U100 in 205 insulin-naïve patients with type 2 diabetes, the median duration of hypoglycemic episodes was similar across all four treatment arms. An episode was measured from when the continuous glucose monitoring interstitial glucose level fell below 3.9 mmol/L (70 mg/dL) for at least 15 minutes to the point it returned to above this cutoff for a minimum of 15 minutes.
Specifically, median overall hypoglycemic episode duration was 35 minutes for people assigned to receive icodec with a self-measured blood glucose target of 4.4–7.2 mmol/L (80–130 mg/dL) and maximum icodec dose adjustment of either 21 or 28 units/week (titration groups A and B).
Median episode duration was 39 minutes in icodec titration group C, which had a blood glucose target of 3.9–6.0 mmol/L (70–108 mg/dL) and maximum dose adjustment of 28 units/week, and was 35 minutes in the group assigned to receive glargine with a glucose target of 4.4–7.2 mmol/L and maximum adjustment of 4 units/day.
Furthermore, the proportion of time spent below 3.0 mmol/L (54 mg/dL) during a hypoglycemia episode was comparable across icodec titration groups A, B, and C, and was not longer than that observed with glargine, at 20.6%, 18.2%, 14.4%, and 21.0%, respectively.
Silver reported that hypoglycemia durations were also similar regardless of treatment assignment in the second trial, which assessed 154 people with type 2 diabetes receiving daily basal insulin and switching to insulin icodec with or without a 100% loading dose or insulin glargine U100.
In this case, median overall hypoglycemic episode duration was 40 minutes in the groups that received icodec with and without a loading dose and 35 minutes among those given glargine. The corresponding proportions of time spent below 3.0 mmol/L during a hypoglycemia episode were 14.1%, 16.8%, and 18.5%.
In both studies, similar results were seen when only nocturnal data were analyzed and there was no clustering of hypoglycemic episodes for either icodec or glargine throughout the 16-week treatment duration.
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