Glycemic control with basal insulin compared to DPP-4-inhibitors

Kuiper JG et al., Nederlands Tijdschrift voor Diabetologie 2017;15(1):5-10

Objective: To compare glycemic control in diabetes patients starting basal insulin or dipeptidyl-peptidase-4 (DPP-4) inhibitors.

Methods: From the PHARMO Database Network, diabetes patients ≥ 18 years starting DPP-4 inhibitor or basal insulin between 2007-2012 were selected. The association between treatment and HbA1c change was determined with univariate and multivariate regression analysis. A sensitivity analysis was performed on patients matched on baseline HbA1c and gender.

Results: The mean (± SD) baseline HbA1c was 66.1 (± 12.7) mmol/mol among 205 DPP-4 inhibitor users and 67.8 (± 12.2) mmol/mol among 941 basal insulin users. HbA1c change was greater for basal insulin and insulin glargine 100 U/ml. After matching, HbA1c change was greater for DPP-4 inhibitors compared to basal insulin, but remained smaller compared to insulin glargine 100 U/ml users.

Conclusion: In daily practice, a greater HbA1c change was seen in patients using basal insulin and insulin glargine 100 U/ml. However, when matching on baseline HbA1c and gender, only insulin glargine 100 U/ml had a greater HbA1c change.

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