The BRIGHT study (a “head-to-head” comparison of insulin Glargine 300 U/ml and insulin Degludek 100 U/ml): The comments on the more recent analyses of results

Czech version

Authors: Emil Martinka
Authors‘ workplace: Národný endokrinologický a diabetologický ústav, n. o., Ľubochňa
Published in: Forum Diab 2020; 9(1): 61-67
Category:

Overview

Insulin Glargine 300 U/ml (iGla300) is an effective and safe second-generation basal insulin analogue. In the “head-to-head” BRIGHT study, the comparison with insulin Degludek 100 U/ml (iDeg100) in patients with type 2 diabetes mellitus (T2DM), previously not treated with insulin, led to a comparable modification of glycemic control (HbA_1c, fasting glycemia, intraday variability, the proportion of patients who reached the target values HbA_1c without occurrence of hypoglycemia, overall occurrence of hypoglycemia, weight gain), however with a lower occurrence of hypoglycemia in the titration phase. Besides that, it has been shown that the lower occurrence of hypoglycemia in the titration phase is also associated with a lower occurrence of hypoglycemia in the subsequent maintenance phase. In the subanalyses, iGla300 led to a more effective modification of HbA_1c in the risk groups, specifically in patients aged > 70 and in patients with estimated glomerular filtration (eGF) < 60 ml/min/1.73m²while the occurrence of hypoglycemia remains the same. This protection is undoubtedly of practical importance for clinical practice, since the lower risk of hypoglycemia in the titration phase is undoubtedly linked to the patient’s greater confidence in the treatment and better adherence, which may encourage them to a more effective titration of basal insulin to achieve the target values of glycemic control. iGla300 also turns out to be an effective and safe insulin for older patients and those with eGF < 60 ml/min/1.73 m².

Keywords:

insulin Glargine 300 U/ml – BRIGHT study – insulin Degludek 100 U/ml – eGF < 60 ml/min/1.73 m²

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