TITLE:
Glycemic Variability and Acute Complications in Type 1 Diabetes: A Non-Randomized Comparative Cross-Sectional Study of Basaglar and Non-Basaglar Use in a Tanzanian Tertiary Hospital
AUTHORS:
Asmaa Kimaro, Edna Majaliwa, Khamswan Bakari Kimaro, Kaushik Ramaiya, Victor Mwakalobo, Renatus Fabiano Nyarubamba, Levina Msuya, Aisa Shayo
KEYWORDS:
Glycemic Variability, Continuous Glucose Monitoring, Insulin Glargine, NPH Insulin, Type 1 Diabetes Mellitus, Tanzania
JOURNAL NAME:
Open Journal of Endocrine and Metabolic Diseases,
Vol.16 No.10,
October
16,
2026
ABSTRACT: Background and Aims: Type 1 Diabetes Mellitus (T1DM) requires lifelong insulin therapy, and glycemic variability provides clinically useful information beyond HbA1c by describing short-term glucose fluctuations. This study compared CGM-derived glycemic variability and acute glucose excursions among Basaglar and non-Basaglar users attending a tertiary diabetes clinic in Tanzania. Methods: This prospective, non-randomized comparative cross-sectional study included 200 patients aged 6 - 26 years with T1DM attending the diabetic clinic at Kilimanjaro Christian Medical Centre (KCMC) during 2023-2024. Participants were classified according to the basal insulin regimen they were already receiving: Basaglar (insulin glargine; n = 105) or NPH/Insulatard (n = 95); treatment was not assigned by the investigators. CGM was performed for 14 days using the FreeStyle Libre Pro iQ system. All analyzed records were reported as 100% sensor-active over the monitoring period. Glycemic variability was defined by coefficient of variation (CV), calculated from glucose standard deviation (SD) and mean glucose, and categorized as acceptable (CV ≤ 36%) or unacceptable (CV > 36%). CGM ranges were defined as TIR 70 - 180 mg/dL, TAR > 180 mg/dL, and TBR Results: Among Basaglar users, 84/105 (80.0%) had acceptable glycemic variability and 21/105 (20.0%) had unacceptable variability. Among non-Basaglar users, 14/95 (14.7%) had acceptable glycemic variability and 81/95 (85.3%) had unacceptable variability. In unadjusted analysis, Basaglar use was associated with lower odds of unacceptable glycemic variability than NPH/Insulatard use (cOR 0.043, 95% CI 0.021 - 0.091; P