A Randomized Controlled Trial Comparing the Efficacy and Safety of IDegLira Versus Basal-Bolus in Patients With Poorly Controlled Type 2 Diabetes and Very High HbA1c ≥9–15%: DUAL HIGH Trial

Galindo, Rodolfo J.; Moazzami, Bobak; Scioscia, Maria F.; Zambrano, Cesar; Albury, Bonnie; Saling, Jarrod; Vellanki, Priyathama; Pasquel, Francisco J.; Davis, Georgia; Fayfman, Maya; Peng, Limin; Umpiérrez, Guillermo E.

doi:10.2337/dc22-2426

Cited by 4 publications

(5 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…30 Furthermore, IDegLira has recently emerged as a valid and simple alternative to a complex BB insulin regimen for patients with T2D and poorly controlled diabetes, as documented by very high HbA1c (9%-15%). 31 The extent of HbA1c reductions in both groups of patients was consistent with that obtained in other Italian observational studies 21,22 and similar to that reported in the European retrospective study, 25 but also with the results of the randomized controlled trials of the DUAL programme. [7][8][9][10][11][12] In DUAL-V, patients on basal-only insulin randomized to IDegLira had a greater HbA1c reduction of 0.6% than those randomized to continuing and uptitrating basal insulin.…”

Section: Discussionsupporting

confidence: 90%

See 1 more Smart Citation

IDegLira for the real‐world treatment of type 2 diabetes in Italy. Final results from the REX observational study

Fadini,

Buzzetti,

Pitocco

et al. 2024

Diabetes Obesity Metabolism

View full text Add to dashboard Cite

AimThe study was designed to generate real‐world evidence on IDegLira in the Italian clinical practice in two groups of patients with type 2 diabetes (T2D), switching to IDegLira either from a basal only (basal group) or basal‐bolus insulin regimen (BB group).Materials and MethodsThis was a non‐interventional, multicentre, single‐cohort, prospective study assessing the long‐term glycaemic control in patients with T2D, who switched to IDegLira from a basal insulin ± glucose‐lowering medication regimen with or without a bolus insulin component for approximately 18 months, conducted in 28 Italian diabetes centres. The primary endpoint was the change in glycated haemoglobin (HbA1c) levels from baseline to 6 months after IDegLira initiation.ResultsThe study included 358 patients with a mean age 67.2 years and diabetes duration of 15.7 years. HbA1c significantly decreased from IDegLira start to all study time points in the overall population (basal group −1.19%; BB group −0.60% at the end of observation). Patients achieving HbA1c <7% levels increased from 12.9% (n = 43) to 40.3% (n = 110) at 18 months. Fasting blood glucose and body weight also significantly decreased in both groups, although more in the BB group. Overall, 14.3% of completed patients had an intensification of treatment (mainly in the basal group) and 48.6% had a simplification of treatment (mainly in the BB group).ConclusionsSwitching to IDegLira in a real‐world clinical setting is a valid therapeutic option for patients with T2D with inadequate glycaemic control on basal or BB insulin regimen and/or need to simplify their insulin therapy, with specific reasons and therapeutic goals according to different T2D management trajectories.

show abstract

Section: Discussionsupporting

confidence: 90%

“…Moreover, IDegLira is also economically advantageous up to a dosage of 25 units compared with the BB combination 30 . Furthermore, IDegLira has recently emerged as a valid and simple alternative to a complex BB insulin regimen for patients with T2D and poorly controlled diabetes, as documented by very high HbA1c (9%‐15%) 31 …”

Section: Discussionmentioning

confidence: 99%

IDegLira for the real‐world treatment of type 2 diabetes in Italy. Final results from the REX observational study

Fadini,

Buzzetti,

Pitocco

et al. 2024

Diabetes Obesity Metabolism

View full text Add to dashboard Cite

show abstract

“…Also, the CONCLUDE trial reported no significant difference in the rate of overall symptomatic hypoglycaemia with IDeg-200 vs Gla-300 and nominally lower rates of nocturnal symptomatic and severe hypoglycaemia with IDeg-200 vs Gla-300 [ 79 ]. Compared to the basal-bolus regimen, FRC of IDeg and liraglutide (IDegLira) in PwT2D and HbA 1c ≥ 9.0–15.0% led to a similar reduction in HbA 1c and less hypoglycaemia and weight gain compared with the basal-bolus regimen [ 80 ]. The findings from DELIVER-High Risk study showed that participants on Gla-300 had numerically lower incidences and event rates for all hypoglycaemia and mainly significantly lower incidences and event rates for hypoglycaemia associated with inpatient/ED contacts compared to Gla-100 or IDet [ 81 ].…”

Section: Discussionmentioning

confidence: 99%

Expert Opinion on Current Trends in the Use of Insulin in the Management of People with Type 2 Diabetes from the South-Eastern European Region and Israel

Tabak,

Kempler,

Guja

et al. 2024

Diabetes Ther

View full text Add to dashboard Cite

Despite the availability of various antihyperglycaemic therapies and comprehensive guidelines, glycaemic control in diabetes management has not improved significantly during the last decade in the real-world clinical setting. Treatment inertia arising from a complex interplay among patient-, clinician- and healthcare-system-related factors is the prime reason for this suboptimal glycaemic control. Also, the key factor leading to inadequate glycaemic levels remains limited communication between healthcare professionals (HCPs) and people with type 2 diabetes (PwT2D). Early insulin administration has several advantages including reduced glucotoxicity, high efficacy and preserved β-cell mass/function, leading to lowering the risk of diabetes complications. The current publication is based on consensus of experts from the South-Eastern European region and Israel who reviewed the existing evidence and guidelines for the treatment of PwT2D. Herein, the experts emphasised the timely use of insulin, preferably second-generation basal insulin (BI) analogues and intensification using basal-plus therapy, as the most-potent glucose-lowering treatment choice in the real-world clinical setting. Despite an increase in the use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs), the experts urged timely insulin initiation for inadequate glycaemic control in PwT2D. Furthermore, the combination of BI and GLP-1 RA addressing both fasting plasma glucose and post-prandial excursions as a free- or fixed-ratio combination was identified to reduce treatment complexity and burden. To minimise discontinuation and improve adherence, the experts reiterated quality, regular interactions and discussions between HCPs and PwT2D/carers for their involvement in the diabetes management decision-making process. Clinicians and HCPs should consider the opinions of the experts in accordance with the most recent recommendations for diabetes management.

show abstract

“… 24 97 For people with marked hyperglycaemia (eg, HbA 1c >10% or with symptoms), clinicians should start insulin, or a combination of insulin with GLP1RAs. 98 When improved glycaemic control is achieved, many people with type 2 diabetes can be safely transitioned to non-insulin treatments with close monitoring to prevent hypoglycemia and hyperglycemia.…”

Section: Drug Treatment Of Type 2 Diabetesmentioning

confidence: 99%

“…Basal bolus insulin treatment requires more injections, more glucose testing, more education, and carries a higher risk of hypoglycaemia and weight gain. 98 Metformin or complication centric drugs (GLP1RAs and SGLT2is), or both, should be continued. Sulfonylureas should be discontinued because of the risk of hypoglycaemia with concurrent insulin treatment.…”

Section: Starting and Titrating Insulin Treatmentmentioning

confidence: 99%

Advances in the management of type 2 diabetes in adults

Galindo,

Trujillo,

Low Wang

et al. 2023

bmjmed

View full text Add to dashboard Cite

Type 2 diabetes is a chronic and progressive cardiometabolic disorder that affects more than 10% of adults worldwide and is a major cause of morbidity, mortality, disability, and high costs. Over the past decade, the pattern of management of diabetes has shifted from a predominantly glucose centric approach, focused on lowering levels of haemoglobin A1c(HbA1c), to a directed complications centric approach, aimed at preventing short term and long term complications of diabetes, and a pathogenesis centric approach, which looks at the underlying metabolic dysfunction of excess adiposity that both causes and complicates the management of diabetes. In this review, we discuss the latest advances in patient centred care for type 2 diabetes, focusing on drug and non-drug approaches to reducing the risks of complications of diabetes in adults. We also discuss the effects of social determinants of health on the management of diabetes, particularly as they affect the treatment of hyperglycaemia in type 2 diabetes.

show abstract

A Randomized Controlled Trial Comparing the Efficacy and Safety of IDegLira Versus Basal-Bolus in Patients With Poorly Controlled Type 2 Diabetes and Very High HbA1c ≥9–15%: DUAL HIGH Trial

Cited by 4 publications

References 19 publications

IDegLira for the real‐world treatment of type 2 diabetes in Italy. Final results from the REX observational study

IDegLira for the real‐world treatment of type 2 diabetes in Italy. Final results from the REX observational study

Expert Opinion on Current Trends in the Use of Insulin in the Management of People with Type 2 Diabetes from the South-Eastern European Region and Israel

Advances in the management of type 2 diabetes in adults

Contact Info

Product

Resources

About