Comparing the effects of insulin glargine and thiazolidinediones on plasma lipids in type 2 diabetes: A patient-level pooled analysis

Ajay Chaudhuri, Julio Rosenstock, Andres Digenio, Luigi Meneghini, Priscilla Hollander, Janet B. McGill, Paresh Dandona, John Ilgenfritz, Matthew Riddle

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

Background: The prevalence of dyslipidaemia and the risk of cardiovascular disease are elevated in patients with type 2 diabetes. This analysis compared the effects of insulin glargine versus thiazolidinediones (TZDs) on lipid profiles. Methods: Patient-level data were pooled from two randomized clinical studies. The population included 552 men and women aged >18years, diagnosed with type 2 diabetes for at least 6months, on metformin and/or sulphonylurea, and with A 1C ≥7.5% and <12.0% at screening. Lipid outcome measures included change from baseline in lipid levels [low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), total cholesterol, triglycerides, and free fatty acids] and attainment of lipid goals for LDL-C, non-HDL-C, and triglycerides. Results: Both insulin glargine and TZDs improved lipid profiles from baseline values. Compared with TZDs, treatment with insulin glargine led to 7.9% greater reduction in LDL-C (p<0.0003), 7.5% greater reduction in non-HDL-C (p<0.0001), and 7.8% greater reduction in total cholesterol (p<0.0001), whereas the HDL-C increase with TZD was 7.6% greater than that with insulin glargine (p<0.0001). The percentage of patients attaining the lipid goals was comparable between insulin glargine and pioglitazone, but lower for rosiglitazone. Insulin glargine improved glycaemic control more than TZDs; however, insulin glargine caused more hypoglycaemia. Treatment with TZDs caused more weight gain and peripheral oedema. Conclusion: These findings suggest that the favourable effects of insulin glargine on plasma lipid profiles should be considered among the advantages of treatment with insulin glargine as they are for TZDs.

Original languageEnglish (US)
Pages (from-to)258-267
Number of pages10
JournalDiabetes/Metabolism Research and Reviews
Volume28
Issue number3
DOIs
StatePublished - Mar 2012

Keywords

  • Insulin glargine
  • Lipids
  • Thiazolidinediones
  • Type 2 diabetes

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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