Differential glycaemic control with basal insulin glargine 300 U/mL versus degludec 100 U/mL according to kidney function in type 2 diabetes - a subanalysis from the BRIGHT trial.

AIMS: Chronic kidney disease (CKD) challenges diabetes management and is associated with increased cardiovascular morbidity and mortality. We examined whether clinical outcomes with insulin glargine 300 U/mL (Gla-300) and insulin degludec 100 U/mL (IDeg-100) are affected by renal function in a pre-specified subgroup analysis from the BRIGHT trial. MATERIALS AND METHODS: BRIGHT (NCT02738151) was a multicentre, open-label, randomised, active-controlled, two-arm, parallel-group, 24-week study in insulin-naive uncontrolled type 2 diabetes (T2D). Participants were randomised 1:1 to evening Gla-300 (n=466) or IDeg-100 (n=463) and stratified based on baseline estimated glomerular filtration rate (eGFR) for this analysis. RESULTS: Heterogeneity of treatment effect across renal function subgroups was observed (p=0.02), reflecting a greater mean HbA1c reduction from baseline to week 24 with Gla-300 versus IDeg-100 in the eGFR /=90 mL/min/1.73 m(2) . CONCLUSIONS: Kidney function seems to impact the glucose-lowering effects of Gla-300 versus IDeg-100 in insulin-naive T2D. Greater HbA1c reductions with Gla-300 without increase in hypoglycaemia risk, were observed in patients with eGFR <60 mL/min/1.73 m(2) . This article is protected by copyright. All rights reserved.