Published online Apr 15, 2020. doi: 10.4239/wjd.v11.i4.100
Peer-review started: November 27, 2019
First decision: January 15, 2020
Revised: February 25, 2020
Accepted: March 12, 2020
Article in press: March 12, 2020
Published online: April 15, 2020
Processing time: 130 Days and 18.4 Hours
Despite the availability of a variety of insulins, rates of insulinisation and the acceptance of insulin therapy is suboptimal in real-world clinical settings. Patient and physician concerns with hypoglycaemia and weight gain are the two key issues that serve to impede appropriate insulinisation in patients with diabetes. Recently introduced second-generation basal insulin analogues [for e.g., insulin glargine 300 U/mL (Gla-300) and insulin degludec] are designed to have improved pharmacokinetic profiles with an intention to deliver steady insulin levels over a longer period. Several randomised controlled and real-world studies have proven the resultant advantages of second-generations insulin analogues in lowering intra-individual variability in plasma insulin levels, flexibility in dosing, a sustained glucose-lowering effect, and decreasing the risk of hypoglycaemia. Gla-300 is one of the newer second-generation basal insulin analogues to have been approved for both type 1 and 2 diabetes. In this article, we review the currently available clinical and real-world data of Gla-300.
Core tip: Despite being a crucial therapeutic option in patients with diabetes, there is a clinical inertia for use of insulin due to fear of hypoglycaemia, weight gain, and complexity of insulin regimens or dosing. Insulin intensification is perceived to be associated with disease worsening, impeding optimal insulin titration and adequate glycaemic control. Insulin glargine 300, the second-generation long-acting insulin analogue, provides an extended and stable action profile, sustained glucose lowering, reduced risk of hypoglycaemia, less weight gain, and flexibility of dosing schedule. This review illustrates the clinical efficiency and safety demonstrated by insulin glargine 300 in randomised clinical trials and real-world studies.