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

Abstract

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.

Use and effectiveness of a fixed‐ratio combination of insulin degludec/liraglutide (IDegLira) in a real‐world population with type 2 diabetes: Results from a European, multicentre, retrospective chart review study

“…In contrast to the accumulating data from clinical trials, real‐world evidence on IDegLira is limited. Findings from an observational study in patients with T2D and suboptimal glycaemic control on >2 OADs and >1 injection/day at a single Swiss centre ( n = 61) showed that IDegLira resulted in glycated haemoglobin (HbA1c) reductions, weight loss and a reduced total insulin dose after 6 months' treatment compared with baseline . Similar results were also observed in a small ( n = 12) UK study; however, real‐world data from a larger patient population that is more varied, in terms of baseline therapy, region and number of centres involved, is needed and may help to inform the prescribing decisions of clinicians.…”

“…Findings from an observational study in patients with T2D and suboptimal glycaemic control on >2 OADs and >1 injection/day at a single Swiss centre (n = 61) showed that IDegLira resulted in glycated haemoglobin (HbA1c) reductions, weight loss and a reduced total insulin dose after 6 months' treatment compared with baseline. 24 Similar results were also observed in a small (n = 12) UK study 25 ; however, real-world data from a larger patient population that is more varied, in terms of baseline therapy, region and number of centres involved, is needed and may help to inform the prescribing decisions of clinicians. The aim of the present European Xultophy Treatment Retrospective Audit (EXTRA) study was to evaluate the clinical use and effectiveness of IDegLira in a real-world population of adults with T2D, under conditions that reflect routine clinical care.…”

Metabolic Control and Adherence to Therapy in Type 2 Diabetes Mellitus Patients Using IDegLira in a Real-World Setting

“…They are also supported by the findings of several previous studies that have examined the effect of the IDegLira FRC in real-world setting. In all of these studies, a substantial and significant [16][17][18][19].…”

Clinical Considerations When Initiating and Titrating Insulin Degludec/Liraglutide (IDegLira) in People with Type 2 Diabetes

“…There was also no clinically significant increase in self-measured blood glucose (SMBG) in any pretrial dose group when switching to IDegLira, and no withdrawals due to hyperglycemia with IDegLira in the first 8 weeks following the switch [83]. Furthermore, results from a real-world population of people with T2D (92% of whom were being treated with insulin) demonstrated that switching to IDegLira resulted in improved glucose control and body weight loss [84]. The data from both clinical trials and real-world studies therefore suggest that IDegLira can be an effective and often superior substitution for any basal insulin dose [83,84].…”

“…Furthermore, results from a real-world population of people with T2D (92% of whom were being treated with insulin) demonstrated that switching to IDegLira resulted in improved glucose control and body weight loss [84]. The data from both clinical trials and real-world studies therefore suggest that IDegLira can be an effective and often superior substitution for any basal insulin dose [83,84]. Additionally, results from DUAL VII demonstrate that in people whose diabetes was not controlled with basal insulin, IDegLira provides comparable HbA 1c reductions as basal-bolus insulin, with significantly lower hypoglycemia rates and weight loss compared with weight gain [40].…”