Treatment intensification following glucagon‐like peptide‐1 receptor agonists in type 2 diabetes: Comparative effectiveness analyses between different basal insulins. RESTORE ‐G real‐world study
Authors' conclusion
2BI are a valuable option to intensify GLP-1 RA therapy. Switching to Gla-300 versus Deg-100 was associated with greater HbA1c improvement.
Study context
- Population
- People with T2D starting basal insulin as add-on to (ADD-ON) or in substitution of (SWITCH) GLP-1 RA therapy, electronic medical records of 32 Italian diabetes clinics
- Exposure
- Second- vs first-generation basal insulin (2BI vs 1BI) and Gla-300 vs Deg-100, added to or switched from GLP-1 RA
- Outcome
- HbA1c
- Follow-up
- 6 months
Methodological detailsreal-world, propensity score adjusted, multicentre (32 Italian diabetes clinics)
- Real-world
- Propensity score adjusted
- Multicentre (32 Italian diabetes clinics)
Main finding
As reported in the abstract
Estimated mean difference, % (95% CI)P value
2BIvs 1BIADD-ON cohort (N = 700)
−0.32(−0.62 to −0.02)
P = 0.042BIvs 1BISWITCH cohort (N = 2097)
−0.22(−0.42 to −0.02)
P = 0.03Gla-300vs Deg-100SWITCH cohort starting 2BI (N = 688)
−0.89(−1.26 to −0.52)
P < 0.001Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value |
|---|---|---|
| FBG, ADD-ON cohort (N = 700) · 6 months2BI vs 1BI · propensity score adjusted | −20.73 mg/dl (95% CI −35.62 to −5.84) | P = 0.007 |
| FBG, SWITCH cohort · 6 months2BI vs 1BI · propensity score adjusted | −10.15 mg/dl (95% CI −19.04 to −1.26) | P = 0.03 |
| Body weight, SWITCH cohort · 6 months2BI vs 1BI · propensity score adjusted | −0.67 kg (95% CI −1.30 to −0.04) | P = 0.04 |
| FBG, SWITCH cohort starting 2BI · 6 monthsGla-300 vs Deg-100 · propensity score adjusted | −17.89 mg/dl (95% CI −32.45 to −3.33) | P = 0.02 |
HbA1c, SWITCH cohort (N = 2097) · 6 months
- Propensity score adjusted
HbA1c, SWITCH cohort starting 2BI (N = 688) · 6 months
- Propensity score adjusted
HbA1c, propensity score matching sensitivity analysis
- Benefit on HbA1c confirmed with propensity score matching
- −0.55% (95% CI −1.02; −0.08); p = .02
- Sensitivity analysis
Original publication
Treatment intensification following glucagon‐like peptide‐1 receptor agonists in type 2 diabetes: Comparative effectiveness analyses between different basal insulins. RESTORE ‐G real‐world study. Diabetes Obes Metab. Published 10 June 2024. doi:10.
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