Clemens KK, Ouédraogo AM, Lam M, et al. - Analyzing trends in basal insulin prescribing in older adults with CKD, a reduction in basal insulin use in this population has been observed in an era of new oral and injectable diabetes medications. However, basal insulin, especially newer analogues, continue to be a mainstay treatment in those with more advanced CKD.

• In this population-based study, adults ≥66 years with treated diabetes between January 1 2010 to September 1 2020 in Ontario, Canada, were analyzed.

• An about 2-fold higher use of basal insulin was observed in CKD vs in the general treated diabetes cohort.

• Over time, decline in NPH prescriptions was noted, while prescriptions for Levemir and glargine-100 increased until 2018 and then decreased.

• A substantial increase in prescriptions for glargine-300 and degludec was evident after drug formulary approval (September 2018).

• In CKD, reduction in incident prescriptions for basal insulin was evident over time; however, rates continued to be stable in those with an estimated glomerular filtration rate <30ml/min/1.73m ² .

• Rates of degludec and glargine-300 have rivalled glargine-100 during recent years.