Rationale for the Use of Combination Injectable Therapy in Patients With Type 2 Diabetes Who Have High A1C (≥9%) and/or Long Duration (>8 Years): Executive Summary

Abstract

Recommended A1C targets for people with type 2 diabetes are between 6.5 and 8%; however, real-world data suggest that an increasing proportion of people with diabetes have suboptimal control, and~15% have an A1C level .9%. People with A1C .9% are at increased risk for micro-and macrovascular complications and require treatment intensification to improve glycemic control as early as possible. In a series of short videos now available on the Clinical Diabetes website, the authors discuss the pathophysiological changes that occur during the progression of type 2 diabetes, with particular focus on the key role of declining b-cell function. The authors review clinical characteristics-long diabetes duration and A1C $9%-that are indicative of diminishing b-cell function, and they discuss the clinical data that support the use of available treatment options for these individuals, consistent with current diabetes treatment guidelines.

Cardiovascular and microvascular outcomes with iGlarLixi versus iDegLira: A real‐world, population‐based cohort study

“…3 Most patients with T2D eventually require combination injectable therapy in addition to oral agents to maintain glycaemic control. 4 Fixed-ratio combinations (FRCs) consist of basal insulin and a glucagon-like peptide-1 receptor agonist (GLP-1 RA) in a single injection. Two FRCs are currently available, iGlarLixi (insulin glargine U-100/ lixisenatide) and iDegLira (insulin degludec U-100/liraglutide).…”