Glycaemic control and hypoglycaemia risk with insulin glargine 300 U/mL and insulin degludec 100 U/mL in older participants in the BRIGHT trial.
2021
In older populations with type 2 diabetes (T2D), individualised target HbA1c should be achieved with minimal hypoglycaemia, and therapies should be tested for both safety and efficacy. BRIGHT was the first head-to-head randomized trial comparing insulin glargine 300 U/mL (Gla-300) and insulin degludec 100 U/mL (IDeg-100) in insulin-naive adults with T2D. In this sub-analysis, endpoints were studied by predefined (≥65 years, N = 596/333) and post-hoc (≥70 years, N = 768/161) age groups. Heterogeneity of treatment effect was observed for HbA1c reductions in the ≥70 years, but not ≥65 years, populations, with greater HbA1c reductions with Gla-300 versus IDeg-100 in the ≥70 years subgroup (least squares mean - 0.34% [95% confidence interval: -0.589 to -0.100]). There was no significant heterogeneity of treatment effect for incidence and rates of confirmed (≤3.9 mmol/L [≤70 mg/dL]) hypoglycaemia across any age subgroups over 24 weeks, but numerically lower incidence and rates were consistently observed for Gla-300 versus IDeg-100 in the ≥65 and ≥ 70 years age groups in the initial 12 weeks. Further investigation is required to determine Gla-300 glycaemic benefits in these high-risk populations without increasing hypoglycaemia risk. This article is protected by copyright. All rights reserved.
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