Insulin glargine effective for treating nonobese and obese Type 2 diabetics

9 March 2010

MedWire News: Results from a subgroup analysis of the ATLANTUS trial show that treatment with insulin glargine is effective for lowering glycated hemoglobin (HbA1c), without substantial weight gain, in obese and nonobese individuals with Type 2 diabetes.

Weight gain is a side effect associated with many antidiabetes medications, which can be a problem as many patients with Type 2 diabetes are overweight or obese. Hypoglycemia is also a common problem and can have serious after effects.

In this study, Kamlesh Khunti (University of Leicester, UK) and team assessed the efficacy of insulin glargine treatment for reducing HbA1c and its effects on weight and frequency of hypoglycemia in 4555 patients with Type 2 diabetes. Of these, 1833 (40%) were classified as obese and had body mass indices (BMIs) over 30 kg/m² and 2722 (60%) were nonobese.

The study took place over 24 weeks and patients were treated with investigator-titrated or self-managed titrated insulin glargine.

The obese and nonobese groups had mean BMIs of 33.7 kg/m² and 25.9 kg/m², respectively. The team found that HbA1c was reduced significantly from baseline in both subgroups by 1.15%, but there was no significant difference between the obese and nonobese groups. There was also no significant difference between the proportion of patients achieving an HbA1c below 7.0% at 6 months between the two groups.

Patients who were nonobese gained an average of 1.21 kg over the study period compared with 1.08 kg in the obese group, but the difference between the two groups was not statistically significant.

Severe hypoglycemia did not differ significantly between the two groups, but significantly more nonobese than obese patients had nocturnal hypoglycemic episodes, at 4.5% versus 2.5%.

“Treatment with insulin glargine in people with Type 2 diabetes mellitus was associated with a significant reduction in HbA1c without differential increase in weight gain in obese and non-obese subgroups,” conclude Khunti et al in the journal Diabetes Obesity and Metabolism.

In addition: “Rates of severe hypoglycaemia were not different between obese and non-obese subgroups.”

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Diabetes Obes Metab 2010; Advance online publication