Researchers have revealed that the benefits of the long-acting insulin analog "glargine" in reducing hypoglycemia episodes among diabetes patients in resource-limited countries may not appear until a year after starting treatment.
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This adds new data to the debate regarding the feasibility of using modern insulin analogs compared to traditional human insulin in these settings.
The study was conducted by researchers from the University of Pittsburgh and included 400 children and young adults aged between 7 and 25 years with type 1 diabetes in Bangladesh and Tanzania. The objective was to compare the efficacy of traditional human insulin with the long-acting insulin analog "glargine."
The results showed that after six months of treatment, there were no differences between the two groups in the study's two primary outcomes: the time patients spent within the target range for blood sugar levels, and the time spent in the severe hypoglycemia range.
However, the picture changed after 12 months, as the duration of severe hypoglycemia episodes and the number of nocturnal hypoglycemia episodes decreased for patients who received "glargine" compared to those who received traditional treatment. In contrast, the study recorded no statistically significant differences between the two groups in glycated hemoglobin (HbA1c) levels, rates of diabetic ketoacidosis, or acute or symptomatic hypoglycemia episodes.
Additionally, the use of "glargine" was associated with a lower total daily insulin dose and fewer daily injections—advantages that could ease the burden on patients and their families, as well as reduce pressure on healthcare systems.
Dr. Jing Luo, an associate professor of medicine at the University of Pittsburgh and the lead author of the study, said the question is not only whether newer types of insulin are better than older ones, but whether the benefits they achieve justify their high cost when making procurement decisions and establishing treatment guidelines in resource-limited countries.
These findings gain particular importance given the ongoing global disparity in access to type 1 diabetes treatments. According to the researchers, the number of people living with the disease globally is estimated at 9.5 million, about 3.2 million of whom rely solely on traditional human insulin. Most of them live in low- and middle-income countries, where the high prices and limited availability of modern insulin analogs remain barriers to their widespread use.
Although the World Health Organization included long-acting insulin analogs, such as "glargine," in its Model List of Essential Medicines in 2021, the researchers believe that additional studies are needed to understand the long-term impacts of switching from traditional human insulin to insulin analogs on blood sugar control in resource-limited settings.
The study was published in the journal The Lancet Diabetes & Endocrinology.
Source: Medical Xpress
