Basal insulin peglispro beats glargine for glycemic control

(HealthDay)—For patients with type 2 diabetes, basal insulin peglispro (BIL) provides better glycemic control than insulin glargine, with increased triglycerides, aminotransferases, and liver fat content, according to a study published online Nov. 23 in Diabetes Care.

John B. Buse, M.D., Ph.D., from the University of North Carolina School of Medicine in Chapel Hill, and colleagues conducted a 52-week trial to examine the efficacy and safety of BIL versus insulin glargine in patients with type 2 diabetes. Patients with a mean hemoglobin A1c (HbA1c) of 7.42 percent were randomly allocated to BIL (307 patients) or glargine (159 patients).

The researchers found the reduction in HbA1c to be superior with BIL versus glargine at 26 weeks (−0.82 versus −0.29 percent; P < 0.001); the greater reduction with BIL was maintained at 52 weeks. At weeks 26 and 52, more BIL patients achieved HbA1c <7 percent (P < 0.001). Nocturnal hypoglycemia was 60 percent lower with BIL versus glargine; furthermore, HbA1c <7 percent was achieved without nocturnal hypoglycemia in more patients at 26 and 52 weeks (P < 0.001), and total hypoglycemia rates were lower at 52 weeks (P = 0.03) for BIL. For BIL versus glargine, glucose variability was lower, basal insulin dose was higher, and triglycerides and aminotransferases were higher at weeks 26 and 52.

"BIL provided superior glycemic control versus glargine, with reduced nocturnal and total hypoglycemia, lower glucose variability, and increased triglycerides, aminotransferases, and liver fat content," the authors write.

Several authors disclosed financial ties to pharmaceutical companies, including Eli Lilly, which funded the study.