Rates of hypoglycaemia are lower in patients treated with insulin degludec/liraglutide (IDegLira) than with IDeg or insulin glargine, regardless of the hypoglycaemia definition used

Abstract

AimsTo re‐analyse, using a series of alternative hypoglycaemia definitions, the data from 2 trials, DUAL I and V, in which the once‐daily, fixed ratio combination of insulin degludec/liraglutide (IDegLira) was compared with basal insulin therapy.Material and Methods Post hoc analyses of the DUAL I (patients uncontrolled on oral antidiabetic drugs) and DUAL V (patients uncontrolled on insulin glargine (IGlar) U100) trials were carried out using different definitions of hypoglycaemia and according to whether treatments were administered in the morning or afternoon. Rates of hypoglycaemia for the definitions of confirmed and American Diabetes Association (ADA)‐documented symptomatic hypoglycaemia were compared according to age, gender and body mass index (BMI).ResultsAlthough hypoglycaemia rates differed according to the alternative hypoglycaemia definitions, rates were consistently lower with IDegLira vs insulin degludec (IDeg) and IGlar U100. Despite glycated haemoglobin concentrations being lower with IDegLira at end of treatment, confirmed and nocturnal‐confirmed hypoglycaemia rates were lower for IDegLira vs IDeg and IGlar U100, irrespective of dosing time. The definitions of confirmed and ADA‐documented symptomatic hypoglycaemia did not have a significant effect on the treatment difference between IDegLira and IDeg, liraglutide or IGlar U100 when further assessed by baseline age, gender and BMI.ConclusionsTreatment with IDegLira, vs IDeg and IGlar U100, resulted in lower rates of hypoglycaemia regardless of dosing time and definition of hypoglycaemia used. The choice of hypoglycaemia definition did not influence the results of analyses when stratified by age, sex and BMI.

Superior efficacy with a fixed‐ratio combination of insulin degludec and liraglutide (IDegLira) compared with insulin degludec and liraglutide in insulin‐naïve Japanese patients with type 2 diabetes in a phase 3, open‐label, randomized trial

“…There was a significantly lower rate of severe or blood glucose‐confirmed hypoglycaemic episodes with liraglutide compared with IDegLira. This outcome was expected, because of the presence of the insulin component and the glucose‐dependent mode of action of GLP‐1RAs …”

“…This outcome was expected, because of the presence of the insulin component and the glucosedependent mode of action of GLP-1RAs. 33 A significantly smaller increase in body weight was seen with IDegLira (2.9 kg) compared with degludec (4.1 kg), probably as a result of the weight-reducing effect of liraglutide. 20 This significant difference is in alignment with findings from the global trial programme.…”