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

Kalayci Fulya Mete; Kızılay Deniz Ozalp; Gunay Demir; Samim Ozen; Damla Gokşen

doi:10.1530/endoabs.110.P362

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Endocrine Abstracts (2025) 110 P362 | DOI: 10.1530/endoabs.110.P362

ECEESPE2025 Poster Presentations Diabetes and Insulin (143 abstracts)

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

Fulya Mete Kalayci ¹ , Deniz Özalp Kızılay ¹ , Günay Demir ¹ , Samim Özen ¹ & Damla Gökşen ¹

Author affiliations

¹Ege University Faculty of Medicine, Division of Pediatric Endocrinology and Diabetes, İzmir, Türkiye

JOINT1954

Introduction: Insulin glargine 300 U/mL (Gla-300), a second-generation basal insulin, has shown in phase 3 trials to provide better glycemic control than insulin glargine 100 U/mL (Gla-100), while reducing hypoglycemia risk and glycemic variability. However, real-world data in the pediatric age group is limited. This study aims to evaluate the impact of switching from Gla-100 to Gla-300 on glycemic control in children and adolescents with type 1 diabetes (T1D).

Methods: The study included 20 patients aged 8-20 years with T1D who were using continuous glucose monitoring (CGM) systems and transitioned from Gla-100 to Gla-300. Glycemic parameters assessed before and three months after the transition.

Results: Mean age and mean duration of diabetes was 13. 14 ± 2. 89, 4. 71±3. 26 years, respectively. The mean age at transition to Gla-300 was 12. 58 ± 2. 85 years. Glycemic data from the patients’ CGM is shown in Table 1. Basal insulin ratio increased significantly (P = 0. 036), and an increase in total insulin dose was also observed, although it was not statistically significant. No significant changes were found in glycemic parameters, nor was there a reduction in the number of hypoglycemic events or the time below range before and after the transition.

Table 1: Glycemic Parameters Before and After Transition in the Patients
	Glargine U100	Glargine U300	p
Weight SDS	0. 35 ± 0. 99	0. 51 ± 1. 10	0. 113
Total Insulin Dose (IU/kg/day)	0. 75 ± 0. 24	0. 81 ± 0. 22	0. 082
Basal Insulin Ratio (%)	42 ± 15	48. 39 ± 7. 86	0. 036
HbA1c (%)	7. 79 ± 1. 18	7. 60 ± 0. 75	0. 376
Stage 2 (>250 mg/dL)	11. 61 ± 10. 91	13. 63 ± 12. 82	0. 486
TAR (Time above range) (180-250 mg/dL)	24. 22 ± 8. 48	24. 47 ± 6. 97	0. 540
TIR (Time in range) (70-180 mg/dL)	60. 11 ± 12. 72	58. 79 ± 16. 64	0. 505
TBR (Time below range) (54-70 mg/dL)	3. 5 ± 3. 13	2. 68 ± 2. 00	0. 316
Stage 2 (<54 mg/dL)	0. 67 ± 1. 28	0. 47 ± 1. 12	0. 616
GMI (glucose management index) (%)	7. 25 ± 0. 68	7. 23 ± 0. 49	0. 966
CV (Coefficient of variation) (%)	37. 41 ± 4. 03	52. 64 ± 62. 7	0. 309
Active Sensor Time (%)	83. 11 ± 16. 88	89. 11 ± 15. 26	0. 091
Average Blood Glucose (mg/dL)	164. 39 ± 29. 08	168. 33 ± 31. 45	0. 480
Hypoglycemic Events	7. 38 ± 6. 22	6. 69 ± 4. 09	0. 622

Conclusion: Gla-300 provides glycemic control similar to Gla-100, but with a higher basal insulin ratio, without significant differences in overall glycemic outcomes.

Key words: Pediatric, Glarjin U100, Glarjin U300