Real-World Evaluation of Glycemic Outcomes and Extra-Glycemic Parameters in Diabetic Patients Treated with the Combined Formulation Degludec–Liraglutide (Ideglira)

Zenari, Luciano; Porto, Andrea Da; Moliner, Lorena De; Lugli, Francesca; Guazzoni, Valeria; Groppelli, Gloria; Molteni, Laura; Bracaccia, Massimo; Frison, Vera; Simioni, Natalino; Bonsembiante, Barbara; Miranda, Cesare; Lapolla, Annunziata

doi:10.1007/s13300-020-00945-4

Cited by 13 publications

(21 citation statements)

References 19 publications

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“…In addition, after 12 months of treatment, reductions in both HbA1c (−2.2 mmol/mol [−0.2%], p > 0.05) and body weight (−6.2 kg, p < 0.001) were observed, albeit in fewer people. Transitioning to IDegLira from BBI therapy was also associated with a significant reduction in TDD of −27.0 and −31.6 U at 6 and 12 months, respectively 30 . Hypoglycaemia was not reported in this study.…”

Section: Overview Of the Clinical Evidence For Transitioning To A Com...contrasting

confidence: 45%

“…The search terms are presented in Table S1. The search results were discussed by the author group and relevant articles were identified; 19–33 these are summarised in Tables 1 and 2 19–33 …”

Section: Methodsmentioning

confidence: 99%

“…In the DUAL VII randomised controlled trial (RCT), IDegLira showed comparable reductions in HbA1c compared with BBI 34 . Statistical reductions in HbA1c were reported for IDegLira compared with BBI in observational studies, 19,21,30 and for iGlarLixi in a post hoc propensity‐score‐matched analysis of two RCTs 35 …”

Section: Rationale For Transitioning To a Fixed‐ratio Combination Of ...mentioning

confidence: 98%

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Transitioning from basal–bolus or premix insulin therapy to a combination of basal insulin and glucagon‐like peptide‐1 receptor agonist in people with type 2 diabetes

et al. 2022

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Aims: Two fixed-ratio combinations (FRCs) of basal insulin and glucagon-like peptide-1 receptor agonist (GLP-1RA) are available for once-daily use in adults with type 2 diabetes. We aimed to review the clinical evidence for the efficacy and safety of changing treatment from a basal-bolus insulin (BBI) regimen or a premix insulin to these combination treatments (fixed-ratio or loose) and provide expert opinion on the practicalities of making such a change. Methods: Relevant clinical and trial evidence and general review articles were identified through a literature review of ProQuest (comprising BIOSIS Previews®, Current Contents® Search, Embase® and MEDLINE®) for articles published between 2009 and 2021. Results:We identified nine articles reporting the results of FRCs, and seven articles reporting results of loose combinations of basal insulin and GLP-1RAs, in people who transitioned treatment from BBI or premix regimens. In most trials, combination treatment led to improved or equivalent glycaemic control, and a reduction in body weight or BMI, versus the original regimens. Some trials reported a reduction in total insulin dose. A few trials reported reduced or unchanged hypoglycaemia rates, or increased patient satisfaction, with combination therapy where these endpoints were examined. We provide guidance on transitioning of treatment and the patient types most likely to benefit. Conclusions:In people not achieving glycaemic control with BBI or premix insulin regimens, an FRC or loose combination of basal insulin and GLP-1RA may improve control, decrease the risk of body weight gain or hypoglycaemia and reduce the complexity of treatment.

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Section: Overview Of the Clinical Evidence For Transitioning To A Com...contrasting

confidence: 45%

Section: Methodsmentioning

confidence: 99%

Section: Rationale For Transitioning To a Fixed‐ratio Combination Of ...mentioning

confidence: 98%

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Transitioning from basal–bolus or premix insulin therapy to a combination of basal insulin and glucagon‐like peptide‐1 receptor agonist in people with type 2 diabetes

et al. 2022

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“…Although, iDegLira more decrease total cholesterol and LDL, but these differences were not signi cant. Other studies showed better lipid pro l with xed ratio combination (25)(26)(27)(28)(29)(30). Unlike other results which had not showed diffrence in HDL level, our results also had showed increase in HDL level in iGlarLixi groups.…”

Section: Discussionmentioning

confidence: 93%

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

Risovic

Dumanovic

Bojic

et al. 2022

Preprint

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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.

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“…IDegLira initiation resulted in improved HbA 1c and weight loss in japanese patients ( 13 ). The findings from the Italian study show that in a real-world setting, the switch to IDegLira treatment is a valid option for patients who are failing to achieve glycemic control targets and/or struggling with the side effects, such as weight gain and hypoglycemia, of other insulin therapies ( 14 ). In real-world practice, after 6 months and at a moderate dose, in patients previously on insulin treatment IDegLira resulted in substantial reductions in HbA1c and body weight, with a reduced risk of hypoglycaemia ( 15 ) Our study compared parameters of metabolic control in diabetic patients on two or three doses of premix insulin (an insulin regimen containing both basal and bolus components) with patients who were switched to a fixed combination containing basal insulin and GLP 1 receptor agonist.…”

Section: Discussionmentioning

confidence: 99%

IDegLira Improves Metabolic Control in Patients with Type 2 Diabetes Previously Treated with Premix Insulin

Bostandzic¹,

Beslic²,

Surkovic³

et al. 2022

Med Arch

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Background: IDegLira( fixed combination of GLP 1 receptor agonist and insulin) has been shown to be effective in improving the glucoregulation in patients previously treated with oral therapy as well as individual components, GLP-1 receptor agonist or basal insulin. Objective: The aim of this study is to examine the parameters of metabolic control in patients treated with IDegLira who were previously treated with premix insulin in several daily doses and to compare them with patients whose premix insulin dose was increased. Methods: The study included 100 patients who had been previously treated with two or three daily doses of premix insulin. Half of the patients were switched to IdegLira( group I), and half (group II) had their insulin dose increased according to the clinical assessment of the physician. Fasting glucose, 2h postprandial glucose, HbA1c, BMI and insulin dose were determined at baseline and at follow-up after 6 months. Results: Patients treated with IDegLira compared to patients whose insulin dose was increased achieved significantly lower fasting glucose (p <0.001), postprandial glucose (p <0.001), HbA1c (p <0.001), BMI (p <0.001) with a significantly lower insulin dose (p <0.001). Comparison of the same parameters within the groups of patients at the beginning and after 6 months showed that patients who were switched from insulin premix to IDegLira achieved significantly lower fasting blood glucose (p <0.001), postprandial glucose (p <0.001), HbA1c (p < 0.001), BMI (p <0.001) with significantly lower insulin dose within the fixed combination (p <0.001). Patients with gradually increased insulin dose achieved significant reduction in fasting glucose (p = 0.021) and postprandial glucose (p = 0.036),but with a significantly higher insulin dose (p = 0.005). There was also a slight increase in BMI that was not statistically significant (p = 0.267). Conclusion: The obtained data suggest that switching patients from a complex insulin regimen to a fixed combination of basal insulin and GLP 1 receptor agonist in comparison to increases in insulin dose results in a significant improvement in fasting glucose, postprandial glucose, HbA1c, and BMI. The results were achieved with a significantly lower daily insulin dose.

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Real-World Evaluation of Glycemic Outcomes and Extra-Glycemic Parameters in Diabetic Patients Treated with the Combined Formulation Degludec–Liraglutide (Ideglira)

Cited by 13 publications

References 19 publications

Transitioning from basal–bolus or premix insulin therapy to a combination of basal insulin and glucagon‐like peptide‐1 receptor agonist in people with type 2 diabetes

Transitioning from basal–bolus or premix insulin therapy to a combination of basal insulin and glucagon‐like peptide‐1 receptor agonist in people with type 2 diabetes

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

IDegLira Improves Metabolic Control in Patients with Type 2 Diabetes Previously Treated with Premix Insulin

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