Direct Comparison Two Fixed-ratio Combination Glucagon-like Peptide Receptor Agonist and Basal Insulin on Glycemic and Non Glycemic Parameters in Type 2 Diabetes

Abstract

Background. Two types of fixed-ratio combinations of basal insulin and a glucagon-like protein-1 receptor agonist (GLP-1RA) have been approved for use in type 2 diabetes. One is insulin degludec/liraglutide(iDergLira), and the other is insulin glargine/lixisenatide (iGlarLixi). Direct comparisons between these two combination is not available. Methods. The retrospective study included 186 patients with type 2 DM with inadequate glycemic control on metformin and basal insulin (degludec, glargin 100, glargin 300) who were switched fixed-ratio combination GLP-1 RA and basal insulin.Patients were divided into two groups based on the basal insulin before study: group I ( n = 86) treated with degludec were switched to iDegLira and patients group II ( n = 99), 48 treated with glargin were switched to iGlarLixi. The aim of this study was to direct compare the effect between two fixed – ratio combination on glycemic parameters and non glycemic parameters. Follow up was 6 months. Results . Mean HbA1c decreased similarly (-1.2% vs.-1.1%). Higher percentage patients in iDegLira group had reached the HbA1c < 7% after 6 months ( 22% vs. 18.2%, p < 0.05). The mean change in FPG was comparable for the two groups, while mean decrease PPG level were lower in iGlarLixi group (2 vs 1.8 mmol/l, p > 0.05). Change in body weight were significant difference in iDegLira group (1.8 kg vs. 0.7 kg, p < 0.001). At the end of the study patients showed decreased in total cholesterol and LDL for 0.2 mmol/L in iDegLira, 0.1 mmol/l in iGlarLixi, triglycerids for 0.3 mmol/l in both groups, increase HDL for 0.1 mm/l in iGlarLixi. Conclusion . Our results showed that more patients with iDegLira had HbA1c less than 7% and these combination had better effect on weight loss. There were no difference on FPG and PPG, lipid profile and rate of hypoglycemia.