P-296: Effects of transition from basal insulin glargine 100 u/mL to 300 u/mL on glycemic control in children and adolescents with type 1 diabetes - real-world data
F Mete Kalayci, D Ozalp Kizilay, G Demir, H Isiklar, S Ozen, D GoksenAbstract
Introduction
Insulin glargine 300 U/mL (Gla-300) provides better glycemic control with lower hypoglycemia risk than insulin glargine 100 U/mL (Gla-100) in phase 3 trials. However, real-world data in the pediatric population remains limited.
Objectives
We aimed to evaluate the impact of switching from Gla-100 to Gla-300 on glycemic parameters in children and adolescents with type 1 diabetes (T1D).
Methods
Twenty patients (8–20 years) using continuous glucose monitoring (CGM) who transitioned from Gla-100 to Gla-300 were retrospectively analyzed. Glycemic parameters [time in range (TIR), time above range (TAR), time below range (TBR), mean glucose, coefficient of variation (CV), glucose management indicator (GMI), hypoglycemic events, and HbA1c] were evaluated at baseline and 3-month intervals up to 12 months post-transition.
Results
Mean age and diabetes duration were 13.14±2.89 and 4.71±3.26 years, respectively. No statistically significant changes were observed in HbA1c, TIR, TAR, TBR, mean glucose, CV, or GMI during the 12-month follow-up. Conversely, a significant increase was found in BMI SDS (0.70±1.0 to 0.91±1.09; p=0.003) and weight SDS (0.35±0.99 to 0.65±1.22; p=0.026). Total daily insulin dose (IU/kg/day) increased significantly (0.75±0.24 vs 0.96±0.26; p=0.02). The basal insulin ratio (%) increase was significant only at the 3rd month (42±15 vs 48.39±7.86; p=0.036), losing significance thereafter. No severe hypoglycemia occurred, and the trend toward increased hypoglycemic events was not significant (p=0.072).
Conclusions
In this 12-month follow-up, switching to Gla-300 did not show superiority in glycemic parameters over Gla-100. However, increased insulin doses and BMI SDS without improved glycemic control were observed. These findings emphasize the necessity of precise dose optimization and weight monitoring when using Gla-300 in pediatric T1D.