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Benefits of combination of insulin degludec and liraglutide are independent of baseline glycated haemoglobin level and duration of type 2 diabetes
Author(s) -
Rodbard H. W.,
Buse J. B.,
Woo V.,
Vilsbøll T.,
Langbakke I. H.,
Kvist K.,
Gough S. C. L.
Publication year - 2016
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.12574
Subject(s) - liraglutide , insulin degludec , medicine , type 2 diabetes , insulin , diabetes mellitus , hypoglycemia , glucagon like peptide 1 receptor , insulin glargine , urology , endocrinology , agonist , receptor
Aim To evaluate, using post hoc analyses, whether the novel combination of a basal insulin, insulin degludec, and a glucagon‐like peptide‐1 receptor agonist, liraglutide ( IDegLira ), was consistently effective in patients with type 2 diabetes ( T2D ), regardless of the stage of T2D progression. Methods Using data from the DUAL I extension [insulin‐naïve patients uncontrolled on oral antidiabetic drugs ( OADs ), n = 1660, 52 weeks] and DUAL II (patients uncontrolled on basal insulin plus OADs , n = 398, 26 weeks) randomized trials, the efficacy of IDegLira was investigated with regard to measures of disease progression stage including baseline glycated haemoglobin ( HbA1c ), disease duration and previous insulin dose. Results Across four categories of baseline HbA1c (≤7.5–9.0%), HbA1c reductions were significantly greater with IDegLira (1.1–2.5%) compared with IDeg or liraglutide alone in DUAL I . In DUAL II , HbA1c reductions were significantly greater with IDegLira (0.9–2.5%) than with IDeg in all but the lowest HbA1c category. In DUAL I , insulin dose and hypoglycaemia rate were lower across all baseline HbA1c categories for IDegLira versus IDeg , while hypoglycaemia was higher with IDegLira than liraglutide, irrespective of baseline HbA1c . In DUAL II , insulin dose and hypoglycaemia rate were similar with IDegLira and IDeg (maximum dose limited to 50 U) independent of baseline HbA1c . The reduction in HbA1c with IDegLira was independent of disease duration and previous insulin dose but varied depending on pre‐trial OAD treatment. Conclusions IDegLira effectively lowered HbA1c across a range of measures, implying suitability for patients with either early or advanced T2D .