Experience with insulin detemir for type 2 diabetes in older people and people with comorbidities

Abstract

Aims: This real-world study assessed glycemic levels and further clinical outcomes, following initiation of detemir, in sub populations of people with T2D vulnerable to hypoglycemia.

Methods: This retrospective cohort study included people registered in the United Kingdom Clinical Practice Research Datalink (CPRD) GOLD database who initiated detemir between January 2004 and December 2019. Analyses were stratified by age, previous insulin experience, and history of renal, liver or cardiovascular disease (CVD).

Results: In total, 8975 eligible study participants were identified (44.4 %, aged ≥65 years; 23.7 %, renal disease; 15.6 %, CVD; 2.2 %, liver disease; 53.3 %, insulin-naïve). Six months post-index estimated changes (95 % confidence intervals [CI]) in HbA1c and body weight were -1.00 % (-1.1; -0.9) (-11 mmol/mol [-12; -9]) and 0.35 kg (0.03; 0.66), respectively. Rates of hypoglycemia were low, with no increase between pre- and post-index periods. Compared with pre-index, the mean number of oral glucose-lowering therapy prescriptions per person and mean number of people receiving each type of glucose-lowering therapy decreased post-index.

Conclusions: Detemir appears to be an effective and well-tolerated treatment for T2D in older people, and those with CVD, renal disease or liver disease.

Keywords: Basal insulin analog; Comorbidities; Insulin detemir; Older people; Type 2 diabetes.