Glycaemic control, risk of hypoglycaemia and all-cause mortality in new users of second-generation basal insulin with type 2 diabetes and chronic kidney disease: a nationwide register-based cohort study
Authors' conclusion
We found no difference in HbA1c reduction, hospitalisation for hypoglycaemia or all-cause mortality between Gla-300 and Deg-100 in a real-world population of new users with type 2 diabetes and moderate to end-stage chronic kidney disease. Therefore, we conclude that these two treatment options are equally effective and safe in this vulnerable population.
Study context
- Population
- New users of second-generation basal insulin with T2D and moderate to end-stage CKD, entire Danish diabetes population; 44% women
- Participants
- 6,519 new users
- Exposure
- Insulin degludec 100 U/ml vs insulin glargine 300 U/ml
- Deg-100n = 3,747
- Gla-300n = 2,772reference
- Outcome
- Change in HbA1c (with hospitalisation for hypoglycaemia and all-cause mortality)
- Follow-up
- Initiation to end (2020); median 1.0 year
Methodological detailsnationwide, new-user design, mixed-effect models, Poisson models
- Nationwide
- New-user design
- Mixed-effect models
- Poisson models
Main finding
As reported in the abstract
HbA1c reduction · initiation to end of follow-up
Mean HbA1c reduced in both groups from initiation to end of follow-up
13-14 mmol/mol
1.2–1.3%
Largest reduction during the first year
8-9 mmol/mol
0.7–0.8%
Observational data: associations, not effects.
Further findings
| Outcome | Rate ratio (95% CI) | |
|---|---|---|
| All-cause mortalitySimilar between groups | 0.98 (0.84–1.15) | |
| 0.512Rate ratio (log scale) |
Follow-up time
Baseline T2D and CKD duration
- T2D duration and CKD duration significantly shorter in Gla-300
Safety
| Outcome | Rate ratio (95% CI) | |
|---|---|---|
| Hospitalisation for hypoglycaemiaSimilar between groups | 1.02 (0.70–1.49) | |
| 0.512Rate ratio (log scale) |
Original publication
Glycaemic control, risk of hypoglycaemia and all-cause mortality in new users of second-generation basal insulin with type 2 diabetes and chronic kidney disease: a nationwide register-based cohort study. Diabetologia. Published 28 July 2023. doi:10.
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