Proportion and clinical profile of type 1 diabetes patients with a clinical time-action of insulin glargine U100 shorter than 24 hours

Abstract

We aimed to estimate the proportion of type 1 diabetes mellitus (T1DM) patients for whom insulin glargine 100U/ml (Gla-100) does not clinically cover a period of 24 hours and compare them with T1DM patients treated with a single dose of insulin Gla-100. We undertook a cross-sectional observational study of people with T1DM. The study participants were divided into two groups according to the perceived clinical duration of the action of insulin Gla-100. Group 1 (duration 24 hours) comprised participants treated with a single dose of insulin Gla-100; Group 2 (duration <24 hours) comprised participants treated with two doses of insulin Gla-100 or one dose plus premixed insulin with the midday meal. Data were collected on anthropometric measures, treatment and metabolic control. In total, 252 people with T1DM were analysed: 157 from Group 1 and 95 from Group 2. In 37.7% of the participants (95% CI 31.7–43.7%) the clinical duration of Gla-100 was less than 24 hours. The people in Group 2 were older, had longer duration of diabetes and higher BMI. They also required higher doses of insulin and were less insulin sensitive. The independent variables related to the shorter clinical action of insulin Gla-100 were a higher dose of insulin and a longer duration of diabetes. It was concluded a high percentage of patients with T1DM present an effective clinical action of Gla-100 of <24 hours, related to longer duration of diabetes and a need for higher insulin dose. Copyright © 2020 John Wiley & Sons.