"The findings of this study comparing insulin glargine with sitagliptin provide evidence to support the recent ADA-EASD proposal to consider early basal insulin therapy as add-on to metformin to help achieve glycemic control in people with type 2 diabetes," said principal investigator Pablo Aschner, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Colombia.
In insulin-naive people with type 2 diabetes, who were inadequately controlled by metformin once-daily, insulin glargine produced superior HbA1c reduction (-1.7%) versus once daily sitagliptin (-1.1%; p<0.001). Notably 50% more patients on insulin glargine achieved HbA1c <7% (68 vs. 42%) and <6.5% (40 vs. 17%) compared to sitagliptin (p<0.0001 for both), indicating improved glycemic control for a greater number of insulin glargine patients. Additionally, a statistically significant improvement in fasting plasma glucose (FPG), a key contributor to glycemic control, was observed for patients on insulin glargine compared to sitagliptin. The mean difference in self-monitored FPG was -41.4 mg/dL (95% CI: -46.8 to -36.0 mg/dL) lower with insulin glargine than with sitagliptin (p<0.0001).