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 and who were switched to fixed-ratio combination GLP-1 RA and basal insulin: group I-iDegLIra ( n=86) and group II –iGlarLixi ( n= 99). 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, tryglicerids 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.