Fixed-ratio Combinations (basal Insulin Plus GLP-1RA) In Type 2 Diabetes. an Analytical Review Of Pivotal Clinical Trials

Abstract

In type 2 diabetes, therapeutic failure to the oral anti diabetics is frequent, the use of schemes with basal insulin or with multiple doses of insulin (basal insulin and short-acting insulins) are a widely accepted way to intensify therapy. The use of GLP-1 receptor agonists is another intensification strategy. The fixedratio combinations with molecules such as insulin degludec + liraglutide, and insulin glargine + lixisenatide have proven useful in intensifying treatment of individuals with type 2 diabetes. The purpose of this review was to evaluate and analyze the results of pivotal studies with both fixed-ratio combinations in individuals with type 2 diabetes, finding that, they are capable of achieving better glycemic control when compared with each of its components separately (with a lower risk of hypoglycemia vs basal insulin and lower risk of gastrointestinal adverse effects vs GLP-1 receptor agonists) in various clinical scenarios, especially in individuals who do not achieve control with oral antidiabetics or who do not achieve control with basal insulin (associated with oral antidiabetics) or in those under management with GLP-1RA plus oral antidiabetics.

Efficiency of fixed-ratio combination glucagon-like peptide receptor agonist and basal insulin in type 2 diabetes on different therapeutic regimen

“…LixiLan trial with iGlarLixi and Dual trial with iDegLira had shown that aforementioned medications had good potency and e cacy regarding glycemic parameters (4,5,10). Recent studies have shown good glycemic control and safety pro le with xed combination in comparison to intensi cation of oral antidiabetics with premix insulins or addition of prandial insulin in patients previously uncontrolled with basal insulin (17)(18)(19). Bilic Curcic et al have shown that in T2DM patients poorly controlled on different insulin regimens, switching to either one of the available xed ratio combination bene ted glycemic control (2).…”