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CGM-Based Real-World Data on the Transition from Glargine U100 to U300 in Children and Adolescents with Type 1

Gürkan Tarçın1,2

  • 1Pediatric Endocrinology, Kocaeli University Medical Faculty, Kocaeli, Türkiye.

Hormone and Metabolic Research = Hormon- Und Stoffwechselforschung = Hormones Et Metabolisme
|June 12, 2025
PubMed

Insights

Switching from glargine U100 to glargine U300 in children with Type 1 diabetes (T1D) reduced hypoglycemia and glycemic variability. Continuous glucose monitoring (CGM) data showed glargine U300 improved safety without compromising glucose control.

Area of Science:

  • Endocrinology
  • Pediatric Diabetes Management
  • Pharmacological Research

Background:

  • Type 1 diabetes (T1D) management in pediatric populations requires careful insulin selection.
  • Long-acting basal insulins like glargine U100 are commonly used but may have limitations in glycemic control and safety.
  • Continuous glucose monitoring (CGM) provides valuable real-world data for assessing insulin efficacy and safety.

Purpose of the Study:

  • To compare continuous glucose monitoring (CGM) parameters in children and adolescents with Type 1 diabetes (T1D) after transitioning from glargine U100 to glargine U300.
  • To evaluate the efficacy and safety of glargine U300 compared to glargine U100 in a pediatric T1D cohort.
  • To assess the impact of the insulin switch on glycemic variability, hypoglycemia, and time in range.

Main Methods:

  • A cohort of 52 children and adolescents (6-18 years) with T1D using CGM were analyzed.
  • CGM data were collected for two 2-week periods: one before and one after switching from glargine U100 to glargine U300 at the same dose.
  • Dose adjustments for glargine U300 were made every three days based on CGM data. Nighttime glycemic variability was assessed using coefficient of variation (CV) and root mean squared error (RMSE).

Main Results:

  • No significant differences were found in glucose management indicator (GMI) or time in range (TIR) between glargine U100 and glargine U300.
  • Glargine U300 was associated with significantly reduced frequency and duration of hypoglycemia during both 24-hour and nighttime periods.
  • Reduced nighttime glycemic variability was observed with glargine U300, indicated by lower CV and RMSE values. An average 10% increase in basal insulin dose was required post-transition.

Conclusions:

  • Glargine U300 offers a safer profile for pediatric T1D management, primarily by reducing hypoglycemia.
  • The transition to glargine U300 demonstrated improved glycemic stability, particularly during nocturnal hours.
  • CGM-based real-world evidence supports glargine U300 as a beneficial option for enhancing safety and stability in pediatric diabetes care.

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