Type 2 Diabetes Patients Reach Target Glycemic Control Faster Using IDegLira than Either Insulin Degludec or Liraglutide Given Alone

Vilsbøll, Tina; Vora, Jiten; Jarlov, Henrik; Kvist, Kajsa; Blonde, Lawrence

doi:10.1007/s40261-016-0376-0

Cited by 12 publications

(9 citation statements)

References 31 publications

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“…Furthermore, the improvement in HbA 1c in the Swiss patients was detectable at approximately 12 weeks (Fig. 1a), which is consistent with data from randomized clinical trials [22]. Unfortunately, as there were no observations in the period between switching to IDegLira and 12 weeks, it is not possible to determine precisely when the decrease began.…”

Section: Discussionsupporting

confidence: 81%

Glycemic Control in a Real-Life Setting in Patients with Type 2 Diabetes Treated with IDegLira at a Single Swiss Center

Sofra¹

2017

Diabetes Ther

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IntroductionThe aim of the present study was to describe clinical outcomes in a real-world population of Swiss patients with long-standing, poorly controlled type 2 diabetes after switching to IDegLira [a combination of insulin degludec (IDeg) and liraglutide (Lira)].MethodsThis was a prospective, open-label, single-center observational follow-up at the Cabinet Medical de Diabétologie, Lausanne, Switzerland, of 61 patients [HbA1c 9.2% (77 mmol/mol) and 56.1 U total insulin] initiated with IDegLira at 20 dose steps (20 U IDeg/0.72 mg Lira), except in insulin-naïve patients who began treatment at 16 dose steps. Thereafter, the dose was titrated by four dose steps once weekly, according to individualized fasting blood glucose targets. Information about glycemic control, total insulin dose, weight, and blood pressure, along with any adverse events, was collected from medical records and patient reports during clinic visits at baseline, 3 months, and end of follow-up.ResultsOver 6 months of follow-up, mean HbA1c improved (decrease of 1.7%) to 7.5% with concomitant weight loss. Switching to IDegLira resulted in a lower (−14.6 U) total insulin dose compared with baseline for those patients previously on insulin. There were no episodes of severe hypoglycemia during treatment with IDegLira. There were small decreases in both mean systolic and mean diastolic blood pressure with IDegLira. Six patients discontinued treatment early because of adverse gastrointestinal events with IDegLira.ConclusionSwitching to IDegLira, mostly from regimens using insulin in conjunction with oral antidiabetic medications in a real-world population of patients with type 2 diabetes, resulted in improved glucose control with a lower insulin dose and weight loss.Electronic supplementary materialThe online version of this article (doi:10.1007/s13300-017-0234-y) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 81%

Glycemic Control in a Real-Life Setting in Patients with Type 2 Diabetes Treated with IDegLira at a Single Swiss Center

Sofra¹

2017

Diabetes Ther

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“…Indeed, similar results to those reported in the present paper were observed with IDegLira, an FRC of insulin degludec and the long‐acting GLP‐1RA liraglutide. In a post hoc analysis, IDegLira reduced plasma glucose faster and to a greater extent than its components within the first 12 weeks of therapy, without weight gain or an increased risk of hypoglycaemia . Together, these results support the hypothesis that FRCs allow patients with T2D to achieve glycaemic targets earlier than with insulin alone.…”

Section: Discussionsupporting

confidence: 54%

More patients reach glycaemic control with a fixed‐ratio combination of insulin glargine and lixisenatide (iGlarLixi) than with basal insulin at 12 weeks of treatment: A post hoc time‐to‐control analysis of LixiLan‐O and LixiLan‐L

Frías

Puig-Domingo

Meneghini

et al. 2018

Diabetes Obesity Metabolism

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The present post hoc analysis of two 30‐week clinical trials compared efficacy and hypoglycaemia outcomes at early study visits with iGlarLixi (insulin glargine U100 [iGlar] and lixisenatide) vs iGlar alone in patients with type 2 diabetes (T2D) uncontrolled on oral antidiabetic drugs (OADs; LixiLan‐O trial) or basal insulin (LixiLan‐L trial). Time to control, defined as days to achieve glycated haemoglobin (HbA1c) <53 mmol/mol (<7%) or fasting plasma glucose (FPG) ≤7.2 mmol/L, was estimated using the Kaplan–Meier method. In the LixiLan‐O and LixiLan‐L trials, 60% and 46% of patients, respectively, reached HbA1c <53 mmol/mol (<7%) with iGlarLixi at 12 weeks, vs 45% and 24%, respectively, with iGlar. In the LixiLan‐O trial, the median time to target HbA1c was approximately half with iGlarLixi vs iGlar (85.0 vs 166.0 days; P < .0001). In the LixiLan‐L trial, the median time to target HbA1c was 153.0 days with iGlarLixi, while target HbA1c was never reached by 50% of patients with iGlar (P < .0001). Time‐to‐target FPG and hypoglycaemia outcomes were similar between treatments. In T2D uncontrolled on OADs or basal insulin, iGlarLixi resulted in glycaemic control in more patients than did iGlar at early treatment time points.

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“…However, mean A1C was ≤7% at end of trial regardless of baseline A1C category for IDegLira (≤7.5, >7.5 to ≤8.5, >8.5 to ≤9.0%, and >9%) and iGlarLixi (<8% and ≥8%) (47,48). Another post-hoc analysis demonstrated that, for IDegLira, the decrease in A1C was measurable within the first 12 weeks of therapy, without weight gain or increased rate of hypoglycemia (49). A post-hoc analysis of the LixiLan-O and LixiLan-L trials (the latter including insulin-experienced patients), published in abstract form, has indicated that iGlarLixi is associated with less glycemic variability than insulin glargine U100 or lixisenatide alone (50).…”

Section: Efficacy Results In the Trialsmentioning

confidence: 99%

Safety and Efficacy of Insulin Degludec/Liraglutide (IDegLira) and Insulin Glargine U100/Lixisenatide (iGlarLixi), Two Novel Co-Formulations of a Basal Insulin and a Glucagon-Like Peptide-1 Receptor Agonist, in Patients With Diabetes Not Adequately Controlled on Oral Antidiabetic Medications

2018

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Novel co-formulations of basal insulin analogs and glucagon-like peptide-1 (GLP-1) receptor agonists have provided new options for patients with type 2 diabetes who are not reaching recommended glycemic targets. The components of currently available co-formulations (insulin degludec/ liraglutide [IDegLira,] and insulin glargine U100/lixisenatide [iGlarLixi]) act synergistically to address multiple pathophysiologic defects while minimizing the side effects associated with either component when used alone. In Europe, these products are approved for use in patients on regimens of one or more oral antidiabetic drugs; in the United States, they are indicated for use as an adjunct to diet and exercise in patients with type 2 diabetes inadequately controlled with either basal insulin or their respective GLP-1 receptor agonist component. This article reviews key clinical trials in which these products were initiated in insulin-naive patients and describes how they can be safely and effectively titrated in clinical practice.

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Type 2 Diabetes Patients Reach Target Glycemic Control Faster Using IDegLira than Either Insulin Degludec or Liraglutide Given Alone

Cited by 12 publications

References 31 publications

Glycemic Control in a Real-Life Setting in Patients with Type 2 Diabetes Treated with IDegLira at a Single Swiss Center

Glycemic Control in a Real-Life Setting in Patients with Type 2 Diabetes Treated with IDegLira at a Single Swiss Center

More patients reach glycaemic control with a fixed‐ratio combination of insulin glargine and lixisenatide (iGlarLixi) than with basal insulin at 12 weeks of treatment: A post hoc time‐to‐control analysis of LixiLan‐O and LixiLan‐L

Safety and Efficacy of Insulin Degludec/Liraglutide (IDegLira) and Insulin Glargine U100/Lixisenatide (iGlarLixi), Two Novel Co-Formulations of a Basal Insulin and a Glucagon-Like Peptide-1 Receptor Agonist, in Patients With Diabetes Not Adequately Controlled on Oral Antidiabetic Medications

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