The Benefit of Insulin Degludec/Liraglutide (IDegLira) Compared With Basal-Bolus Insulin Therapy is Consistent Across Participant Subgroups With Type 2 Diabetes in the DUAL VII Randomized Trial

Billings, Liana K.; Agner, Bue F Ross; Grøn, Randi; Halladin, Natalie; Klonoff, David C.; Tentolouris, Nikolaοs

doi:10.1177/1932296820906888

Cited by 7 publications

(10 citation statements)

References 22 publications

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“…25 Benefits of IDegLira have also been preserved across subgroups in the DUAL VII study with similar HbA1c reductions, less severe or plasma glucose-confirmed hypoglycaemia, lower end-of-trial total daily insulin dose, together with weight loss relative to meal-time plus basal insulin therapy. 26 The main limitations of the present analysis are, firstly, the exploratory nature of the assessments except for the between-treatment differences in HbA1c and body weight changes in the basal insulin dose and BMI subgroups. However, the data used were entirely those of the original database, and the endpoints were those specified for the main study analysis.…”

Section: Discussionmentioning

confidence: 97%

“…Similar findings were reported in the LixiLan‐O study in insulin‐naïve participants (iGlarLixi vs. insulin glargine 100 U/mL) across subgroups, except for the possibility of higher incidence of hypoglycaemia in the HbA1c ≥64 mmol/mol (≥8.0%) versus <64 mmol/mol subgroup, attributed to differences in dosing 25 . Benefits of IDegLira have also been preserved across subgroups in the DUAL VII study with similar HbA1c reductions, less severe or plasma glucose‐confirmed hypoglycaemia, lower end‐of‐trial total daily insulin dose, together with weight loss relative to meal‐time plus basal insulin therapy 26 …”

Section: Discussionmentioning

confidence: 98%

“… 25 Benefits of IDegLira have also been preserved across subgroups in the DUAL VII study with similar HbA1c reductions, less severe or plasma glucose‐confirmed hypoglycaemia, lower end‐of‐trial total daily insulin dose, together with weight loss relative to meal‐time plus basal insulin therapy. 26 …”

Section: Discussionmentioning

confidence: 99%

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Findings for iGlarLixi versus BIAsp 30 confirmed in groups of people with type 2 diabetes with different biomedical characteristics

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McCrimmon

Rosenstock

et al. 2022

Diabetes Obesity Metabolism

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Aim: To report prespecified and post hoc analyses of the SoliMix dataset exploring the impact of baseline participant characteristics on the original SoliMix study outcomes, to enable informed treatment choices for people with different biomedical characteristics.Methods: SoliMix (EudraCT 2017-003370-13) compared once-daily iGlarLixi (a fixedratio combination of insulin glargine 100 U/mL and the glucagon-like peptide-1 receptor agonist lixisenatide) with twice-daily BIAsp 30 (30% insulin aspart and 70% insulin aspart protamine). In this analysis, the original primary outcomes of noninferiority of iGlarLixi versus BIAsp 30 in terms of glycated haemoglobin (HbA1c) change and superiority in terms of body weight change, together with change in basal insulin dose and hypoglycaemia outcomes, were investigated by baseline age, duration of diabetes, insulin dose, HbA1c level, body mass index (BMI), and renal function.Results: No evidence of difference in comparative treatment effect was detected across baseline age, duration of diabetes, insulin dose, HbA1c level, BMI and renal function subgroups for any endpoint (all heterogeneity P > 0.05), except American Diabetes Association Level 2 hypoglycaemia event rate when stratified by insulin dose (P = 0.011), which may be a chance difference given multiple testing and the small numbers of Level 2 events.Conclusions: Treatment effects of iGlarLixi were consistent irrespective of baseline HbA1c, insulin dose, BMI, age, duration of diabetes and renal function, supporting the use of iGlarLixi as an efficacious and well-tolerated treatment option in people with type 2 diabetes with a wide range of biomedical characteristics.This article has an accompanied Plain Language Summary in the Supporting Information Data S1.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 98%

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Findings for iGlarLixi versus BIAsp 30 confirmed in groups of people with type 2 diabetes with different biomedical characteristics

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McCrimmon

Rosenstock

et al. 2022

Diabetes Obesity Metabolism

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“…Data on demographic characteristics, hematochemical analyses and medications at the last available follow-up were collected. Good control of DM was defined as having fasting glucose <130 mg/dl or HbA1c < 53 mmol/mol ( IDF Clinical Practice Recommendations for, 2017 ; Billings et al, 2021 ). Hypercholesterolemia was defined as being on a lipid-lowering medication and having low-density lipoproteins (LDL) > 100 mg/dl.…”

Section: Methodsmentioning

confidence: 99%

Management of diabetes mellitus in people living with HIV: A single-center experience

et al. 2023

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Background: Diabetes mellitus (DM) is more common in people living with HIV (PLWH) than in HIV-negative patients. Here we aimed to describe the response of PLWH with DM to glucose-lowering therapies in a reference hospital of northern Italy.Setting: 200 PLWH and DM were identified from the database of our clinic.Methods: Good control of DM was defined as having fasting glucose <130 mg/dl or HbA1c < 53 mmol/mol. The distribution of glucose-lowering therapies in PLWH was compared with that of HIV-negative patients with DM.Results: Mean total fasting glucose and HbA1C were 143 ± 50 mg/dl (51% exceeding the 130 mg/dl cutoff) and 51 ± 16 mmol/mol (30% exceeding the 53 mmol/mol cutoff), respectively. PLWH were less treated with dipeptidyl peptidase-4 inhibitors (1.7% versus 9.6%, p < 0.01) and sulfonylureas (3.3% versus 13.2%, p < 0.01), being conversely more frequently treated with metformin (53.8% versus 37.7%, p < 0.01), glifozins plus metformin (7.1% versus 2.0%, p < 0.05) or insulin plus other glucose-lowering agents (5.5% versus 0.5%, p < 0.01).Conclusion: An underuse of dipeptidyl peptidase-4 inhibitors was found which was, however, counterbalanced by a higher use of combination of drugs (including glifozins). A rational assessment of drug-drug interactions would contribute to a better selection of the best glucose lowering agent for each antiretroviral therapy.

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“…IDegLira recipients also had fewer hypoglycaemia events per person-year of exposure vs individuals receiving insulin glargine uptitration (Table 1) [59]. Results from the DUAL VII study showed that IDegLira was non-inferior to basal-bolus insulin treatment (insulin glargine plus insulin aspart) in reducing HbA 1c (P < 0.0001 for non-inferiority) among individuals with inadequate glycaemic control on insulin glargine plus metformin (Table 1) [60]. Similar proportions of participants achieved HbA 1c goals of <53 mmol/mol (<7.0%) and ≤48 mmol/mol (≤6.5%) with both treatments.…”

Section: Fixed-ratio Formulationsmentioning

confidence: 99%

Use of glucagon‐like peptide‐1 receptor agonists among individuals on basal insulin requiring treatment intensification

Trautmann¹,

Vora

2018

Diabet. Med.

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As Type 2 diabetes progresses, treatment is intensified with additional therapies in an effort to manage hyperglycaemia effectively and therefore avoid complications. When greater efficacy is required, options for injectable treatments include glucagon‐like peptide‐1 receptor agonists and insulin, which may be added on to oral glucose‐lowering treatments. Among individuals receiving long‐acting basal insulin as their first injectable treatment, ~40−60% are unable to achieve or maintain their target HbA1c goals. For these people, treatment intensification options are relatively limited and include the addition of short‐acting prandial insulin or a glucagon‐like peptide‐1 receptor agonist. Glucagon‐like peptide‐1 receptor agonists vary in their effects, with short‐ and long‐acting agents having a greater impact on postprandial and fasting hyperglycaemia, respectively. Studies comparing treatment intensification options have found both glucagon‐like peptide‐1 receptor agonists and prandial insulin to be effective in reducing HbA1c concentrations; however, recipients of glucagon‐like peptide‐1 receptor agonists lost weight and had a greater frequency of gastrointestinal adverse events, whereas those receiving prandial insulin gained weight and had a greater incidence of hypoglycaemia. In addition to the separate administration of a glucagon‐like peptide‐1 receptor agonist and basal insulin, fixed‐ratio combinations of a glucagon‐like peptide‐1 receptor agonist and basal insulin offer a single administration for both treatments but have less flexibility in dose titration than treatment with their individual components. For individuals who require treatment intensification beyond basal insulin, use of these various options allows physicians to target the individual needs of their patients for the achievement of optimal long‐term glycaemic control.

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The Benefit of Insulin Degludec/Liraglutide (IDegLira) Compared With Basal-Bolus Insulin Therapy is Consistent Across Participant Subgroups With Type 2 Diabetes in the DUAL VII Randomized Trial

Cited by 7 publications

References 22 publications

Findings for iGlarLixi versus BIAsp 30 confirmed in groups of people with type 2 diabetes with different biomedical characteristics

Findings for iGlarLixi versus BIAsp 30 confirmed in groups of people with type 2 diabetes with different biomedical characteristics

Management of diabetes mellitus in people living with HIV: A single-center experience

Use of glucagon‐like peptide‐1 receptor agonists among individuals on basal insulin requiring treatment intensification

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