medwireNews: Insulin titration benefits individuals with type 2 diabetes regardless of age or whether it is self- or physician-managed, according to data presented at the ADA’s 78th Scientific Sessions in Orlando, Florida, USA.
Krzysztof Strojek, from the Silesian Medical University in Katowice, Poland, reported that there was no significant difference in the reduction in glycated hemoglobin (HbA1c) from baseline to week 24 between self-managed and physician-managed titration of insulin glargine (GLa)-300 among patients younger than 65 years of age (n=329) or among older patients (n=302). The reduction was approximately 1% in all groups.
The reductions in fasting, pre-breakfast self-measured plasma glucose (SMPG) were also similar between titration arms in both age groups, at around 30 mg/dL.
Overall, more than 65% of patients achieved the fasting SMPG target of 80-130 mg/dL, with the rate slightly higher in the self- versus physician-managed patients for both the younger (72.9 vs 63.6%) and older (81.0 vs 75.6%) age groups.
A similar pattern was seen for the composite end point of the fasting SMPG target without confirmed (<54 mg/dL) or severe hypoglycemia.
Taken alone, the rate of hypoglycemia during a 24-hour period did not differ according to management approach in the younger patients.
It was, however, higher among those aged 65 years and older who received physician-led rather than self-managed titration, with 4.79 versus 2.94 events at or below 70 mg/dL per participant–year and 0.76 versus 0.26 events at or below 54 mg/dL per participant–year.
Bodyweight remained constant in all four groups, despite the gradual increase in basal insulin dose with time.
Strojek noted that this post hoc analysis of TAKE CONTROL data confirms the findings from the SENIOR trial, which compared Gla-300 with Gla-100 in patients aged 65 years and older.
He concluded: ”Self-titration with Gla-300 is a suitable therapy option for individuals with type 2 diabetes, including those aged 65 years and older.”
By Laura Cowen
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