Diabetes Mellitus, Type 2
Conditions
Brief summary
The main purpose of this study is to evaluate the safety and efficacy of the study drug known as LY2963016 as compared to LANTUS® in adults with type 2 diabetes mellitus who are on 2 or more oral antihyperglycemic medications (OAMs).
Interventions
Sponsors
Study design
Eligibility
Inclusion criteria
* Have type 2 diabetes mellitus (T2DM). * Have been receiving 2 or more OAMs at stable doses for the 12 weeks prior to screening, with or without basal insulin. * If currently on basal insulin, must be taking LANTUS® QD or NPH or insulin detemir either QD or twice a day for at least 90 days prior to study entry. * Have an HbA1c ≥7.0% and ≤11.0% if insulin naïve; if previously on basal insulin, then HbA1c ≤11.0%. * Body mass index (BMI) ≤45 kilograms per meter squared (kg/m\^2). * As determined by the investigator, are capable and willing to do the following: * perform self monitored blood glucose (SMBG) * complete participant diaries as instructed * are receptive to diabetes education * comply with required study treatment and study visits
Exclusion criteria
* Have been on LANTUS® more than once daily within the previous 30 days. * Have used any other insulin except the entry insulin \[LANTUS®, insulin detemir, or NPH\] including commercial (includes any premixed insulins) and investigational insulins within the previous 30 days. * Have been exposed to a biosimilar insulin glargine within the previous 90 days. * Have participated in a LY2963016 study. * Have taken basal plus mealtime insulin (basal bolus therapy) within the last year for greater than 4 continuous weeks. * Have used any glucagon like peptide (GLP-1) receptor agonists within the previous 90 days. * Have used pramlintide within the previous 30 days. * Have excessive insulin resistance at study entry (total insulin dose ≥1.5 units/kg). * Have more than 1 episode of severe hypoglycemia within 6 months prior to screening. * Have had 2 or more emergency room visits or hospitalizations due to poor glucose control in the 6 months prior to screening. * Have known hypersensitivity or allergy to LANTUS® or its excipients. * Are receiving chronic (lasting longer than 14 consecutive days) systemic glucocorticoid therapy or have received such therapy within 4 weeks immediately preceding screening. * Have obvious signs or symptoms, or laboratory evidence, of liver disease. * Have one of the following concomitant diseases: significant cardiac (e.g., congestive heart failure Class III or IV) or gastrointestinal disease (e.g., significant gastroparesis). * Have a history of renal transplantation or are currently receiving renal dialysis. * Have a serum creatinine greater than 2.0 milligrams/deciliter (177 micromoles/liter). * Have had a blood transfusion or severe blood loss within 3 months prior to screening or have known hemoglobinopathy, hemolytic anemia, or sickle cell anemia. * Participants with active cancer or personal history of cancer within the previous 5 years (with the exception of basal cell carcinoma or carcinoma in situ). * Have a history or diagnosis of Human Immunodeficiency Virus (HIV) infection. * Have any other condition (including known drug or alcohol abuse or psychiatric disorder including dementia) that precludes the participant from following and completing the protocol. * Are pregnant or intend to become pregnant during the course of the study. * Women who are breastfeeding. * Are currently enrolled in, or discontinued within the last 30 days from, a clinical trial involving an investigational product or non-approved use of a drug or device other than LY2963016, or concurrently enrolled in any other type of medical research judged not to be scientifically or medically compatible with this study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change From Baseline to 24 Weeks in Hemoglobin A1c (HbA1c) | Baseline, 24 weeks | HbA1c is the glycosylated fraction of hemoglobin A. HbA1c is measured primarily to identify average plasma glucose concentration over prolonged periods of time. Least Squares (LS) mean was determined by mixed-model repeated measures (MMRM) model with baseline of response, treatment (LY2963016, LANTUS), pooled country, basal insulin at entry (yes/no), sulfonylurea (SU) use (yes/no), visit, treatment and visit\*treatment in the model. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change From Baseline in 7-point Self-Monitored Blood Glucose (SMBG) Values | Baseline, Week 24 | Seven-point SMBG are completed at the following timepoints: Before Morning Meal, 2 Hours After Morning Meal, Before Mid-Day Meal, 2 Hours After Mid-Day Meal, Before Evening Meal, Bed Time and 03:00 AM hours. Least Squares (LS) means was determined by mixed model repeated measures (MMRM) methodology with baseline HbA1c, country, sulfonylurea use, basal insulin status at study entry, visit, treatment and visit\*treatment in the model. |
| Intra-Participant Variability in Fasting Blood Glucose (FBG) | Week 24 | Fasting blood glucose (FBG) is a test to determine how much glucose (sugar) is in a blood sample after an overnight fast. Intra-Participant FBG variability was calculated based on the standard deviation (SD) of the morning pre-meal BG value. Least Squares (LS) means was determined by mixed model repeated measures (MMRM) methodology with baseline HbA1c, country, sulfonylurea use, basal insulin status at study entry, visit, treatment and visit\*treatment in the model. |
| Basal Insulin Dose Units Per Day | Week 24 | Units of Basal Insulin dose taken per day (U/day). Least Squares (LS) means was determined by mixed model repeated measures (MMRM) methodology with baseline of response, baseline HbA1c, country, sulfonylurea use, basal insulin status at study entry, visit, treatment and visit\*treatment in the model. |
| Basal Insulin Dose Per Body Weight (U/kg/Day) | Week 24 | Basal Insulin dose in units (U) per body weight in kilograms (kg) per day. Least Squares (LS) means was determined by mixed model repeated measures (MMRM) methodology with baseline of response, baseline HbA1c, country, sulfonylurea use, basal insulin status at study entry, visit, treatment and visit\*treatment in the model. |
| Percentage of Participants With HbA1c <7% and ≤6.5% | Endpoint [up to 24 weeks] | Hemoglobin A1c (HbA1c) is the glycosylated fraction of hemoglobin A. HbA1c is measured primarily to identify average plasma glucose concentration over prolonged periods of time. |
| Insulin Treatment Satisfaction Questionnaire (ITSQ) Score | Week 4 and Week 24 | ITSQ is a validated instrument containing 22 items that assess treatment satisfaction for participants with diabetes and on insulin. Items divided into 5 domains of satisfaction: Inconvenience of Regimen \[(IR) 5 items: domain scores range (DSR) 5-35\], Lifestyle Flexibility \[(LF) 3 items: DSR 3-21\], Glycemic Control \[(GC) 3 items: DSR 3-21\], Hypoglycemic Control \[(HC) 5 items: DSR 5-35\], Insulin Delivery Device \[(IDD) 6 items: DSR 6-42\]. All items measured on a 7-point scale: 1 (no bother at all) to 7 (a tremendous bother), with lower scores reflecting better outcomes. ITSQ Total Overall Raw Scores range from 22-154. Both raw domain and overall scores are transformed on a scale of 0-100, where transformed score=100\*\[(7-mean raw score)/6\]. Higher scores indicate better treatment satisfaction. LS means was determined by MMRM with baseline of response, baseline HbA1c, country, sulfonylurea use, basal insulin status at study entry, visit, treatment and visit\*treatment in the model. |
| Percentage of Participants With Detectable Anti-Drug Antibodies to LY2963016 or LANTUS® | Endpoint [up to 24 weeks] | The percentage of participants with detected insulin antibodies were summarized as counts and percentages at baseline, at each visit, at the 24-week endpoint (LOCF), and overall for the 24-week treatment period. |
| Rate of Hypoglycemic Events Adjusted Per 1 Year | Baseline through Endpoint [up to 24 weeks] | The rate of hypoglycemic events were analyzed at baseline, titration, maintenance, and overall study periods and at endpoint using the Wilcoxon test. In addition, a negative binomial model was used as a sensitivity analysis. A hypoglycemic event is defined as any time a participant has a blood glucose (BG) level of ≤70 milligrams per deciliter (mg/dL) even if the event was not associated with signs, symptoms, or treatment consistent with current guidelines (American Diabetes Association 2005). Nocturnal hypoglycemia is defined as any hypoglycemic event that occurs between bedtime and waking. Severe hypoglycemia is defined as a hypoglycemic event requiring assistance of another person to actively administer carbohydrates, glucagons, or other resuscitative actions. Severe Hypoglycemic events may or may not have a reported BG ≤70 mg/dL. These events may be associated with sufficient neuroglycopenia to induce seizure or coma. |
| Percentage of Participants With Hypoglycemic Events | Endpoint [up to 24 weeks] | The percentage of participants (with at least 1 hypoglycemic event (total, severe, nocturnal, and others) or incidence during the study was analyzed using Fisher's exact test. A hypoglycemic event is defined as any time a participant has a blood glucose (BG) level of ≤70 milligrams per deciliter (mg/dL) even if the event was not associated with signs, symptoms, or treatment consistent with current guidelines (American Diabetes Association 2005). Nocturnal hypoglycemia is defined as any hypoglycemic event that occurs between bedtime and waking. Severe hypoglycemia is defined as a hypoglycemic event requiring assistance of another person to actively administer carbohydrates, glucagons, or other resuscitative actions. Severe Hypoglycemic events may or may not have a reported BG ≤70 mg/dL. These events may be associated with sufficient neuroglycopenia to induce seizure or coma. |
| Change From Baseline to 24 Weeks in Body Weight | Baseline, 24 Weeks | Change from baseline in body weight. Least Squares (LS) means was determined by mixed model repeated measures (MMRM) methodology with baseline of response, baseline HbA1c, country, sulfonylurea use, basal insulin status at study entry, visit, treatment and visit\*treatment in the model. |
Countries
India, Puerto Rico, Russia, South Korea, Taiwan, Turkey (Türkiye), United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| LY2963016 Insulin naive participants started on 10 units (U) LY2963016 given subcutaneously (SC) once a day (QD) for 24 weeks. Participants entering the study on LANTUS®, insulin detemir or neutral protamine Hagedorn (NPH) QD were started at the same dose SC. Participants entering on insulin detemir or NPH twice a day (BID) were started at 80% of the total daily dose SC. Participants-driven titration was followed to include the addition of 1 U/day until the fasting blood glucose (FBG) level reaches ≤100 mg/dL (5.6 mmol/L). Participants were allowed to continue oral antihyperglycemic medication (OAM). | 249 |
| LANTUS® Insulin naive participants started on 10 U LANTUS® given SC QD for 24 weeks. Participants entering the study on LANTUS®, insulin detemir or NPH QD were started at the same dose SC. Participants entering on insulin detemir or NPH twice a day were started at 80% of the total daily dose SC. Participants-driven titration was followed to include the addition of 1 U/day until the fasting blood glucose (FBG) level reaches ≤100 mg/dL (5.6 mmol/L). Participants were allowed to continue oral antihyperglycemic medication (OAM). | 244 |
| Total | 493 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Adverse Event | 1 | 1 |
| Overall Study | Death | 0 | 1 |
| Overall Study | Lack of Efficacy | 0 | 1 |
| Overall Study | Lost to Follow-up | 2 | 4 |
| Overall Study | Physician Decision | 3 | 4 |
| Overall Study | Protocol Violation | 0 | 1 |
| Overall Study | Withdrawal by Subject | 13 | 7 |
Baseline characteristics
| Characteristic | LANTUS® | Total | LY2963016 |
|---|---|---|---|
| Age, Continuous | 56.98 years STANDARD_DEVIATION 9.86 | 57.40 years STANDARD_DEVIATION 9.35 | 57.82 years STANDARD_DEVIATION 8.83 |
| Baseline Hemoglobin A1c (HbA1c) | 8.56 Percentage of glycosylated hemoglobin STANDARD_DEVIATION 1.02 | 8.61 Percentage of glycosylated hemoglobin STANDARD_DEVIATION 1.06 | 8.66 Percentage of glycosylated hemoglobin STANDARD_DEVIATION 1.09 |
| Duration of Diabetes | 12.26 years STANDARD_DEVIATION 6.45 | 11.92 years STANDARD_DEVIATION 6.4 | 11.59 years STANDARD_DEVIATION 6.34 |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 1 Participants | 1 Participants |
| Race (NIH/OMB) Asian | 118 Participants | 234 Participants | 116 Participants |
| Race (NIH/OMB) Black or African American | 15 Participants | 30 Participants | 15 Participants |
| Race (NIH/OMB) More than one race | 1 Participants | 3 Participants | 2 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 110 Participants | 225 Participants | 115 Participants |
| Region of Enrollment India | 51 Participants | 100 Participants | 49 Participants |
| Region of Enrollment Puerto Rico | 33 Participants | 62 Participants | 29 Participants |
| Region of Enrollment Russia | 26 Participants | 55 Participants | 29 Participants |
| Region of Enrollment South Korea | 45 Participants | 92 Participants | 47 Participants |
| Region of Enrollment Taiwan | 22 Participants | 42 Participants | 20 Participants |
| Region of Enrollment Turkey | 10 Participants | 25 Participants | 15 Participants |
| Region of Enrollment United States | 57 Participants | 117 Participants | 60 Participants |
| Sex: Female, Male Female | 118 Participants | 236 Participants | 118 Participants |
| Sex: Female, Male Male | 126 Participants | 257 Participants | 131 Participants |
| Sulfonylurea Group No, did not use sulfonylurea | 37 Participants | 79 Participants | 42 Participants |
| Sulfonylurea Group Yes, did use sulfonylurea | 207 Participants | 414 Participants | 207 Participants |
| Time of basal insulin injection Daytime | 96 Participants | 195 Participants | 99 Participants |
| Time of basal insulin injection Evening/Bedtime | 148 Participants | 298 Participants | 150 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 75 / 249 | 87 / 244 |
| serious Total, serious adverse events | 10 / 249 | 12 / 244 |
Outcome results
Change From Baseline to 24 Weeks in Hemoglobin A1c (HbA1c)
HbA1c is the glycosylated fraction of hemoglobin A. HbA1c is measured primarily to identify average plasma glucose concentration over prolonged periods of time. Least Squares (LS) mean was determined by mixed-model repeated measures (MMRM) model with baseline of response, treatment (LY2963016, LANTUS), pooled country, basal insulin at entry (yes/no), sulfonylurea (SU) use (yes/no), visit, treatment and visit\*treatment in the model.
Time frame: Baseline, 24 weeks
Population: All randomized participants who received at least 1 dose of study drug and with a Baseline and at least 1 post-Baseline HbA1c measure.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| LY2963016 | Change From Baseline to 24 Weeks in Hemoglobin A1c (HbA1c) | -1.25 Percentage of glycosylated hemoglobin | Standard Error 0.066 |
| LANTUS® | Change From Baseline to 24 Weeks in Hemoglobin A1c (HbA1c) | -1.22 Percentage of glycosylated hemoglobin | Standard Error 0.067 |
Basal Insulin Dose Per Body Weight (U/kg/Day)
Basal Insulin dose in units (U) per body weight in kilograms (kg) per day. Least Squares (LS) means was determined by mixed model repeated measures (MMRM) methodology with baseline of response, baseline HbA1c, country, sulfonylurea use, basal insulin status at study entry, visit, treatment and visit\*treatment in the model.
Time frame: Week 24
Population: All randomized participants who received at least 1 dose of study drug with Baseline and at least 1 post-Baseline Basal Insulin Dose per Body Weight measure.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| LY2963016 | Basal Insulin Dose Per Body Weight (U/kg/Day) | 0.58 units per kilogram per day (U/kg/day) | Standard Error 0.024 |
| LANTUS® | Basal Insulin Dose Per Body Weight (U/kg/Day) | 0.61 units per kilogram per day (U/kg/day) | Standard Error 0.024 |
Basal Insulin Dose Units Per Day
Units of Basal Insulin dose taken per day (U/day). Least Squares (LS) means was determined by mixed model repeated measures (MMRM) methodology with baseline of response, baseline HbA1c, country, sulfonylurea use, basal insulin status at study entry, visit, treatment and visit\*treatment in the model.
Time frame: Week 24
Population: All randomized participants who received at least 1 dose of study drug with Baseline and at least 1 post-Baseline Basal Insulin Dose.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| LY2963016 | Basal Insulin Dose Units Per Day | 49.8 Units per day (U/day) | Standard Error 2.16 |
| LANTUS® | Basal Insulin Dose Units Per Day | 49.7 Units per day (U/day) | Standard Error 2.17 |
Change From Baseline in 7-point Self-Monitored Blood Glucose (SMBG) Values
Seven-point SMBG are completed at the following timepoints: Before Morning Meal, 2 Hours After Morning Meal, Before Mid-Day Meal, 2 Hours After Mid-Day Meal, Before Evening Meal, Bed Time and 03:00 AM hours. Least Squares (LS) means was determined by mixed model repeated measures (MMRM) methodology with baseline HbA1c, country, sulfonylurea use, basal insulin status at study entry, visit, treatment and visit\*treatment in the model.
Time frame: Baseline, Week 24
Population: All randomized participants who received at least 1 dose of study drug with Baseline and at least 1 post-Baseline SMBG measure.
| Arm | Measure | Group | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|---|
| LY2963016 | Change From Baseline in 7-point Self-Monitored Blood Glucose (SMBG) Values | 24 week-Before Mid-Day Meal | -2.14 Millimoles per liter (mmol/L) | Standard Error 0.135 |
| LY2963016 | Change From Baseline in 7-point Self-Monitored Blood Glucose (SMBG) Values | 24 weeks-Before Evening Meal | -1.84 Millimoles per liter (mmol/L) | Standard Error 0.156 |
| LY2963016 | Change From Baseline in 7-point Self-Monitored Blood Glucose (SMBG) Values | 24 week- 2 Hours After Morning Meal | -2.78 Millimoles per liter (mmol/L) | Standard Error 0.161 |
| LY2963016 | Change From Baseline in 7-point Self-Monitored Blood Glucose (SMBG) Values | 24 weeks- Bed Time | -2.14 Millimoles per liter (mmol/L) | Standard Error 0.157 |
| LY2963016 | Change From Baseline in 7-point Self-Monitored Blood Glucose (SMBG) Values | 24 weeks- 2 Hours After Mid-Day Meal | -2.26 Millimoles per liter (mmol/L) | Standard Error 0.158 |
| LY2963016 | Change From Baseline in 7-point Self-Monitored Blood Glucose (SMBG) Values | 24 weeks- 3:00 AM hrs | -2.09 Millimoles per liter (mmol/L) | Standard Error 0.124 |
| LY2963016 | Change From Baseline in 7-point Self-Monitored Blood Glucose (SMBG) Values | 24 week- Before Morning Meal | -2.37 Millimoles per liter (mmol/L) | Standard Error 0.083 |
| LANTUS® | Change From Baseline in 7-point Self-Monitored Blood Glucose (SMBG) Values | 24 weeks- 3:00 AM hrs | -2.09 Millimoles per liter (mmol/L) | Standard Error 0.122 |
| LANTUS® | Change From Baseline in 7-point Self-Monitored Blood Glucose (SMBG) Values | 24 week- Before Morning Meal | -2.69 Millimoles per liter (mmol/L) | Standard Error 0.083 |
| LANTUS® | Change From Baseline in 7-point Self-Monitored Blood Glucose (SMBG) Values | 24 week- 2 Hours After Morning Meal | -3.00 Millimoles per liter (mmol/L) | Standard Error 0.16 |
| LANTUS® | Change From Baseline in 7-point Self-Monitored Blood Glucose (SMBG) Values | 24 week-Before Mid-Day Meal | -2.20 Millimoles per liter (mmol/L) | Standard Error 0.132 |
| LANTUS® | Change From Baseline in 7-point Self-Monitored Blood Glucose (SMBG) Values | 24 weeks- 2 Hours After Mid-Day Meal | -2.42 Millimoles per liter (mmol/L) | Standard Error 0.156 |
| LANTUS® | Change From Baseline in 7-point Self-Monitored Blood Glucose (SMBG) Values | 24 weeks-Before Evening Meal | -2.25 Millimoles per liter (mmol/L) | Standard Error 0.154 |
| LANTUS® | Change From Baseline in 7-point Self-Monitored Blood Glucose (SMBG) Values | 24 weeks- Bed Time | -2.40 Millimoles per liter (mmol/L) | Standard Error 0.156 |
Change From Baseline to 24 Weeks in Body Weight
Change from baseline in body weight. Least Squares (LS) means was determined by mixed model repeated measures (MMRM) methodology with baseline of response, baseline HbA1c, country, sulfonylurea use, basal insulin status at study entry, visit, treatment and visit\*treatment in the model.
Time frame: Baseline, 24 Weeks
Population: All randomized participants who received at least 1 dose of study drug with Baseline and at least 1 post-Baseline body weight measure.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| LY2963016 | Change From Baseline to 24 Weeks in Body Weight | 2.3 Kilogram (kg) | Standard Error 0.28 |
| LANTUS® | Change From Baseline to 24 Weeks in Body Weight | 1.7 Kilogram (kg) | Standard Error 0.29 |
Insulin Treatment Satisfaction Questionnaire (ITSQ) Score
ITSQ is a validated instrument containing 22 items that assess treatment satisfaction for participants with diabetes and on insulin. Items divided into 5 domains of satisfaction: Inconvenience of Regimen \[(IR) 5 items: domain scores range (DSR) 5-35\], Lifestyle Flexibility \[(LF) 3 items: DSR 3-21\], Glycemic Control \[(GC) 3 items: DSR 3-21\], Hypoglycemic Control \[(HC) 5 items: DSR 5-35\], Insulin Delivery Device \[(IDD) 6 items: DSR 6-42\]. All items measured on a 7-point scale: 1 (no bother at all) to 7 (a tremendous bother), with lower scores reflecting better outcomes. ITSQ Total Overall Raw Scores range from 22-154. Both raw domain and overall scores are transformed on a scale of 0-100, where transformed score=100\*\[(7-mean raw score)/6\]. Higher scores indicate better treatment satisfaction. LS means was determined by MMRM with baseline of response, baseline HbA1c, country, sulfonylurea use, basal insulin status at study entry, visit, treatment and visit\*treatment in the model.
Time frame: Week 4 and Week 24
Population: All randomized participants who received at least 1 dose of study drug with Baseline and at least 1 post-Baseline ITSQ measure.
| Arm | Measure | Group | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|---|
| LY2963016 | Insulin Treatment Satisfaction Questionnaire (ITSQ) Score | IR-Week 4 | 85.79 units on a scale | Standard Error 1.32 |
| LY2963016 | Insulin Treatment Satisfaction Questionnaire (ITSQ) Score | IR-Week 24 | 84.75 units on a scale | Standard Error 1.26 |
| LY2963016 | Insulin Treatment Satisfaction Questionnaire (ITSQ) Score | LF-Week 4 | 71.43 units on a scale | Standard Error 1.87 |
| LY2963016 | Insulin Treatment Satisfaction Questionnaire (ITSQ) Score | LF-Week 24 | 72.44 units on a scale | Standard Error 1.77 |
| LY2963016 | Insulin Treatment Satisfaction Questionnaire (ITSQ) Score | HC-Week 4 | 77.82 units on a scale | Standard Error 1.5 |
| LY2963016 | Insulin Treatment Satisfaction Questionnaire (ITSQ) Score | HC-Week 24 | 76.18 units on a scale | Standard Error 1.46 |
| LY2963016 | Insulin Treatment Satisfaction Questionnaire (ITSQ) Score | GC-Week 4 | 79.24 units on a scale | Standard Error 1.45 |
| LY2963016 | Insulin Treatment Satisfaction Questionnaire (ITSQ) Score | GC-Week 24 | 82.14 units on a scale | Standard Error 1.36 |
| LY2963016 | Insulin Treatment Satisfaction Questionnaire (ITSQ) Score | IDD-Week 4 | 82.21 units on a scale | Standard Error 1.23 |
| LY2963016 | Insulin Treatment Satisfaction Questionnaire (ITSQ) Score | IDD-Week 24 | 82.12 units on a scale | Standard Error 1.29 |
| LY2963016 | Insulin Treatment Satisfaction Questionnaire (ITSQ) Score | ITSQ Overall Total-Week 4 | 80.15 units on a scale | Standard Error 1.12 |
| LY2963016 | Insulin Treatment Satisfaction Questionnaire (ITSQ) Score | ITSQ Overall Total-Week 24 | 80.01 units on a scale | Standard Error 1.13 |
| LANTUS® | Insulin Treatment Satisfaction Questionnaire (ITSQ) Score | ITSQ Overall Total-Week 4 | 79.40 units on a scale | Standard Error 1.13 |
| LANTUS® | Insulin Treatment Satisfaction Questionnaire (ITSQ) Score | IR-Week 4 | 84.92 units on a scale | Standard Error 1.33 |
| LANTUS® | Insulin Treatment Satisfaction Questionnaire (ITSQ) Score | GC-Week 4 | 78.87 units on a scale | Standard Error 1.46 |
| LANTUS® | Insulin Treatment Satisfaction Questionnaire (ITSQ) Score | IR-Week 24 | 84.91 units on a scale | Standard Error 1.28 |
| LANTUS® | Insulin Treatment Satisfaction Questionnaire (ITSQ) Score | IDD-Week 24 | 82.01 units on a scale | Standard Error 1.31 |
| LANTUS® | Insulin Treatment Satisfaction Questionnaire (ITSQ) Score | LF-Week 4 | 69.11 units on a scale | Standard Error 1.89 |
| LANTUS® | Insulin Treatment Satisfaction Questionnaire (ITSQ) Score | GC-Week 24 | 81.30 units on a scale | Standard Error 1.38 |
| LANTUS® | Insulin Treatment Satisfaction Questionnaire (ITSQ) Score | LF-Week 24 | 70.87 units on a scale | Standard Error 1.8 |
| LANTUS® | Insulin Treatment Satisfaction Questionnaire (ITSQ) Score | ITSQ Overall Total-Week 24 | 79.76 units on a scale | Standard Error 1.14 |
| LANTUS® | Insulin Treatment Satisfaction Questionnaire (ITSQ) Score | HC-Week 4 | 76.98 units on a scale | Standard Error 1.52 |
| LANTUS® | Insulin Treatment Satisfaction Questionnaire (ITSQ) Score | IDD-Week 4 | 82.37 units on a scale | Standard Error 1.25 |
| LANTUS® | Insulin Treatment Satisfaction Questionnaire (ITSQ) Score | HC-Week 24 | 76.52 units on a scale | Standard Error 1.48 |
Intra-Participant Variability in Fasting Blood Glucose (FBG)
Fasting blood glucose (FBG) is a test to determine how much glucose (sugar) is in a blood sample after an overnight fast. Intra-Participant FBG variability was calculated based on the standard deviation (SD) of the morning pre-meal BG value. Least Squares (LS) means was determined by mixed model repeated measures (MMRM) methodology with baseline HbA1c, country, sulfonylurea use, basal insulin status at study entry, visit, treatment and visit\*treatment in the model.
Time frame: Week 24
Population: All randomized participants who received at least 1 dose of study drug with Baseline and at least 1 post-Baseline fasting blood glucose measure.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| LY2963016 | Intra-Participant Variability in Fasting Blood Glucose (FBG) | 0.81 mmol/L | Standard Error 0.049 |
| LANTUS® | Intra-Participant Variability in Fasting Blood Glucose (FBG) | 0.79 mmol/L | Standard Error 0.049 |
Percentage of Participants With Detectable Anti-Drug Antibodies to LY2963016 or LANTUS®
The percentage of participants with detected insulin antibodies were summarized as counts and percentages at baseline, at each visit, at the 24-week endpoint (LOCF), and overall for the 24-week treatment period.
Time frame: Endpoint [up to 24 weeks]
Population: All randomized participants who received at least 1 dose of study drug and with a Baseline and at least 1 post-Baseline with detectable anti-drug antibodies; last observation carried forward (LOCF).
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| LY2963016 | Percentage of Participants With Detectable Anti-Drug Antibodies to LY2963016 or LANTUS® | 14.5 Percentage of participants |
| LANTUS® | Percentage of Participants With Detectable Anti-Drug Antibodies to LY2963016 or LANTUS® | 17.2 Percentage of participants |
Percentage of Participants With HbA1c <7% and ≤6.5%
Hemoglobin A1c (HbA1c) is the glycosylated fraction of hemoglobin A. HbA1c is measured primarily to identify average plasma glucose concentration over prolonged periods of time.
Time frame: Endpoint [up to 24 weeks]
Population: All randomized participants who received at least 1 dose of study drug with Baseline and at least 1 post-Baseline HbA1c measure; last observation carried forward (LOCF).
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| LY2963016 | Percentage of Participants With HbA1c <7% and ≤6.5% | HbA1c- at 24 week endpoint (LOCF) < 7.0% | 35.0 Percentage of participants |
| LY2963016 | Percentage of Participants With HbA1c <7% and ≤6.5% | HbA1c- at 24 week endpoint (LOCF) <= 6.5% | 20.8 Percentage of participants |
| LANTUS® | Percentage of Participants With HbA1c <7% and ≤6.5% | HbA1c- at 24 week endpoint (LOCF) < 7.0% | 38.3 Percentage of participants |
| LANTUS® | Percentage of Participants With HbA1c <7% and ≤6.5% | HbA1c- at 24 week endpoint (LOCF) <= 6.5% | 18.8 Percentage of participants |
Percentage of Participants With Hypoglycemic Events
The percentage of participants (with at least 1 hypoglycemic event (total, severe, nocturnal, and others) or incidence during the study was analyzed using Fisher's exact test. A hypoglycemic event is defined as any time a participant has a blood glucose (BG) level of ≤70 milligrams per deciliter (mg/dL) even if the event was not associated with signs, symptoms, or treatment consistent with current guidelines (American Diabetes Association 2005). Nocturnal hypoglycemia is defined as any hypoglycemic event that occurs between bedtime and waking. Severe hypoglycemia is defined as a hypoglycemic event requiring assistance of another person to actively administer carbohydrates, glucagons, or other resuscitative actions. Severe Hypoglycemic events may or may not have a reported BG ≤70 mg/dL. These events may be associated with sufficient neuroglycopenia to induce seizure or coma.
Time frame: Endpoint [up to 24 weeks]
Population: All randomized participants who had a post-baseline measurement for Hypoglycemic Events; last observation carried forward (LOCF).
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| LY2963016 | Percentage of Participants With Hypoglycemic Events | Total hypoglycemia with BG ≤70 mg/dL | 68.7 Percentage of participants |
| LY2963016 | Percentage of Participants With Hypoglycemic Events | Severe hypoglycemia | 0 Percentage of participants |
| LY2963016 | Percentage of Participants With Hypoglycemic Events | Nocturnal hypoglycemia with BG ≤70 mg/dL | 49.6 Percentage of participants |
| LY2963016 | Percentage of Participants With Hypoglycemic Events | Non-nocturnal hypoglycemia with BG ≤70 mg/dL | 59.4 Percentage of participants |
| LANTUS® | Percentage of Participants With Hypoglycemic Events | Non-nocturnal hypoglycemia with BG ≤70 mg/dL | 63.0 Percentage of participants |
| LANTUS® | Percentage of Participants With Hypoglycemic Events | Total hypoglycemia with BG ≤70 mg/dL | 69.1 Percentage of participants |
| LANTUS® | Percentage of Participants With Hypoglycemic Events | Nocturnal hypoglycemia with BG ≤70 mg/dL | 46.1 Percentage of participants |
| LANTUS® | Percentage of Participants With Hypoglycemic Events | Severe hypoglycemia | 0.8 Percentage of participants |
Rate of Hypoglycemic Events Adjusted Per 1 Year
The rate of hypoglycemic events were analyzed at baseline, titration, maintenance, and overall study periods and at endpoint using the Wilcoxon test. In addition, a negative binomial model was used as a sensitivity analysis. A hypoglycemic event is defined as any time a participant has a blood glucose (BG) level of ≤70 milligrams per deciliter (mg/dL) even if the event was not associated with signs, symptoms, or treatment consistent with current guidelines (American Diabetes Association 2005). Nocturnal hypoglycemia is defined as any hypoglycemic event that occurs between bedtime and waking. Severe hypoglycemia is defined as a hypoglycemic event requiring assistance of another person to actively administer carbohydrates, glucagons, or other resuscitative actions. Severe Hypoglycemic events may or may not have a reported BG ≤70 mg/dL. These events may be associated with sufficient neuroglycopenia to induce seizure or coma.
Time frame: Baseline through Endpoint [up to 24 weeks]
Population: All randomized participants who received at 1 dose of study drug with Baseline at least 1 post-Baseline hypoglycemic event; last observation carried forward (LOCF).
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| LY2963016 | Rate of Hypoglycemic Events Adjusted Per 1 Year | Total Hypoglycemia with BG ≤70 mg/dL | 16.95 Hypoglycemic events per 1 year | Standard Deviation 23.444 |
| LY2963016 | Rate of Hypoglycemic Events Adjusted Per 1 Year | Severe Hypoglycemia | 0.00 Hypoglycemic events per 1 year | Standard Deviation 0 |
| LY2963016 | Rate of Hypoglycemic Events Adjusted Per 1 Year | Nocturnal Hypoglycemia with BG ≤70 mg/dL | 6.64 Hypoglycemic events per 1 year | Standard Deviation 11.65 |
| LANTUS® | Rate of Hypoglycemic Events Adjusted Per 1 Year | Total Hypoglycemia with BG ≤70 mg/dL | 23.37 Hypoglycemic events per 1 year | Standard Deviation 35.809 |
| LANTUS® | Rate of Hypoglycemic Events Adjusted Per 1 Year | Severe Hypoglycemia | 0.00 Hypoglycemic events per 1 year | Standard Deviation 0.02 |
| LANTUS® | Rate of Hypoglycemic Events Adjusted Per 1 Year | Nocturnal Hypoglycemia with BG ≤70 mg/dL | 7.94 Hypoglycemic events per 1 year | Standard Deviation 17.882 |