Glucagon-like peptide-1 receptor agonist and basal insulin combination treatment for the management of type 2 diabetes: a systematic review and meta-analysis

Eng, Conrad; Kramer, Caroline; Zinman, Bernard; Retnakaran, Ravi

doi:10.1016/s0140-6736(14)61335-0

Cited by 348 publications

(291 citation statements)

References 28 publications

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“…As an alternative, the statement mentioned that, in selected patients, simpler (but somewhat less flexible) premixed formulations of intermediateand short/rapid-acting insulins in fixed ratios could also be considered (44). Over the past 3 years, however, the effectiveness of combining GLP-1 receptor agonists (both shorter-acting and newer weekly formulations) with basal insulin has been demonstrated, with most studies showing equal or slightly superior efficacy to the addition of prandial insulin, and with weight loss and less hypoglycemia (45)(46)(47). The available data now suggest that either a GLP-1 receptor agonist or prandial insulin could be used in this setting, with the former arguably safer, at least for short-term outcomes (45,48,49).…”

Section: Implementation Strategiesmentioning

confidence: 99%

“…Over the past 3 years, however, the effectiveness of combining GLP-1 receptor agonists (both shorter-acting and newer weekly formulations) with basal insulin has been demonstrated, with most studies showing equal or slightly superior efficacy to the addition of prandial insulin, and with weight loss and less hypoglycemia (45)(46)(47). The available data now suggest that either a GLP-1 receptor agonist or prandial insulin could be used in this setting, with the former arguably safer, at least for short-term outcomes (45,48,49). Accordingly, in those patients on basal insulin with one or more oral agents whose diabetes remains uncontrolled, the addition of a GLP-1 receptor agonist or mealtime insulin could be viewed as a logical progression of the treatment regimen, the former perhaps a more attractive option in more obese individuals or in those who may not have the capacity to handle the complexities of a multidose insulin regimen.…”

Section: Implementation Strategiesmentioning

confidence: 99%

See 1 more Smart Citation

Management of Hyperglycemia in Type 2 Diabetes, 2015: A Patient-Centered Approach: Update to a Position Statement of the American Diabetes Association and the European Association for the Study of Diabetes

et al. 2014

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Section: Implementation Strategiesmentioning

confidence: 99%

Section: Implementation Strategiesmentioning

confidence: 99%

Management of Hyperglycemia in Type 2 Diabetes, 2015: A Patient-Centered Approach: Update to a Position Statement of the American Diabetes Association and the European Association for the Study of Diabetes

et al. 2014

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“…GLP‐1RAs reduce food intake and promote weight loss 1 and have the additional benefit of a low risk of hypoglycaemia compared with basal insulin 2, 3. These features may be helpful in overcoming some aspects of clinical inertia with respect to intensifying therapy in patients with T2D 4.…”

Section: Introductionmentioning

confidence: 99%

One‐year efficacy and safety of a fixed combination of insulin degludec and liraglutide in patients with type 2 diabetes: results of a 26‐week extension to a 26‐week main trial

Gough

Bode

Woo

et al. 2015

Diabetes Obesity Metabolism

119

168

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AimsTo confirm, in a 26‐week extension study, the sustained efficacy and safety of a fixed combination of insulin degludec and liraglutide (IDegLira) compared with either insulin degludec or liraglutide alone, in patients with type 2 diabetes.MethodsInsulin‐naïve adults with type 2 diabetes randomized to once‐daily IDegLira, insulin degludec or liraglutide, in addition to metformin ± pioglitazone, continued their allocated treatment in this preplanned 26‐week extension of the DUAL I trial.ResultsA total of 78.8% of patients (1311/1663) continued into the extension phase. The mean glycated haemoglobin (HbA1c) concentration at 52 weeks was reduced from baseline by 1.84% (20.2 mmol/mol) for the IDegLira group, 1.40% (15.3 mmol/mol) for the insulin degludec group and 1.21% (13.2 mmol/mol) for the liraglutide group. Of the patients on IDegLira, 78% achieved an HbA1c of <7% (53 mmol/mol) versus 63% of the patients on insulin degludec and 57% of those on liraglutide. The mean fasting plasma glucose concentration at the end of the trial was similar for IDegLira (5.7 mmol/l) and insulin degludec (6.0 mmol/l), but higher for liraglutide (7.3 mmol/l). At 52 weeks, the daily insulin dose was 37% lower with IDegLira (39 units) than with insulin degludec (62 units). IDegLira was associated with a significantly greater decrease in body weight (estimated treatment difference, −2.80 kg, p < 0.0001) and a 37% lower rate of hypoglycaemia compared with insulin degludec. Overall, all treatments were well tolerated and no new adverse events or tolerability issues were observed for IDegLira.ConclusionsThese 12‐month data, derived from a 26‐week extension of the DUAL I trial, confirm the initial 26‐week main phase results and the sustainability of the benefits of IDegLira compared with its components in glycaemic efficacy, safety and tolerability.

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“…Most of those studies have indicated equal or slightly superior efficacy to the addition of prandial insulin with accompanying weight loss and decreasing hypoglycaemia. [13,14] There are different factors that cause resistance to the initiation of insulin therapy such as beliefs and perceptions concerning diabetes and its treatment and the nature and consequences of insulin therapy. [15] This may also be due to a dislike of the healthcare centres.…”

Section: Introductionmentioning

confidence: 99%

Factors influencing insulin usage among type 2 diabetes mellitus patients: A study in Turkish primary care

Yılmaz

Çim

et al. 2016

European Journal of General Practice

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Background: DM (diabetes mellitus) patients with poorly regulated blood glucose levels are at risk of increased morbidity and mortality. There are different factors that cause resistance to the initiation of insulin therapy such as beliefs and perceptions concerning diabetes and its treatment and the nature and consequences of insulin therapy. Objectives: We aimed to explore the reasons for this reluctance and how these obstacles could be overcome so that DM patients who require insulin could initiate therapy. Methods: This was a cross-sectional, descriptive study of diabetic patients with glycated haemoglobin A 1c (HbA 1C ) levels above 7.0%, who were followed-up at a primary care and endocrinology outpatient clinic. Results: Ninety-four patients (57.4% females, 42.6% males) were recruited for this study. Most patients (57.4%) considered that insulin was a drug of last resort. Among all patients, 34.1% thought that insulin lowered blood glucose levels to an extreme degree and 14.9% disagreed. The patients thought that self-injection was hard (27.6%), required someone else to administer the injection (27.6%), insulin injection was painful (33.0%). 59.6% of all patients believed that their religion did not restrict the use of insulin, 52.1% stated that their family physicians had sufficiently informed them. Conclusion: Our most significant finding is that a lack of adequate information relating to insulin appears to be the major factor behind DM patients' refusal of insulin treatment. The fact that patients consider insulin treatment as a final solution to DM could be related to resistance to the initiation of insulin therapy.

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Glucagon-like peptide-1 receptor agonist and basal insulin combination treatment for the management of type 2 diabetes: a systematic review and meta-analysis

Cited by 348 publications

References 28 publications

Management of Hyperglycemia in Type 2 Diabetes, 2015: A Patient-Centered Approach: Update to a Position Statement of the American Diabetes Association and the European Association for the Study of Diabetes

Management of Hyperglycemia in Type 2 Diabetes, 2015: A Patient-Centered Approach: Update to a Position Statement of the American Diabetes Association and the European Association for the Study of Diabetes

One‐year efficacy and safety of a fixed combination of insulin degludec and liraglutide in patients with type 2 diabetes: results of a 26‐week extension to a 26‐week main trial

Factors influencing insulin usage among type 2 diabetes mellitus patients: A study in Turkish primary care

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