Lixisenatide reduces glycaemic variability in insulin‐treated patients with type 2 diabetes

Chronic hyperglycaemia and glucose variability are associated with the development of chronic diabetes‐related complications. We conducted a pooled analysis of patient‐level data from three 24‐week, randomized, phase III clinical trials to evaluate the impact of lixisenatide ( LIXI ) on glycaemic variability ( GV ) vs placebo as add‐on to basal insulin. The main outcome GV measures were standard deviation (s.d.), mean amplitude of glycaemic excursions ( MAGE ), mean absolute glucose ( MAG ) level, area under the curve for fasting glucose ( AUC‐F ), and high ( HBGI ) and low blood glucose index ( LBGI ). The change in GV metrics over 24 weeks and relationships among baseline GV , patient characteristics and outcomes were assessed. Data were pooled from 1198 patients (665 LIXI , 533 placebo). Values for s.d., MAG level, MAGE , HBGI , and AUC‐F significantly decreased with LIXI vs placebo, while LBGI values were unchanged. Higher baseline GV measures correlated with older age, longer type 2 diabetes duration, lower body mass index, higher baseline glycated/haemogobin, greater reduction in postprandial glucose ( PPG ) level, and higher rates of symptomatic hypoglycaemia. These data show that LIXI added to basal insulin significantly reduced GV and PPG excursions vs placebo, without increasing the risk of hypoglycaemia ( LBGI ).