Basal insulin and glucagon-like peptide 1 receptor agonist (GLP1-RA) combination
Journal Title: Journal of the Indian Medical Association - Year 2018, Vol 116, Issue 3
Abstract
Diabetes mellitus is a chronic disease affecting more than 425 million people worldwide. Patients with type 2 diabetes frequently do not reach HbA1c targets. Historically insulin has been viewed as the most effective glucose-lowering agent in poorly controlled type 2 diabetes. When therapeutic intensification beyond basal insulin plus oral agents is required, adding a bolus, or prandial, rapidacting insulin analog has been recommended either in a stepwise approach or as a full basal-bolus in¬sulin regimen. Adding a GLP-1 receptor agonist to basal insulin may be as effective as adding prandial insulin therapy. Two products, an insulin degludec/liraglutide combination (IDegLira) and an insulin glargine/lixisenatide combination (IGlarLixi), ARE approved for use in adults with T2DM. The efficacy and safety of these two basal insulin/GLP-1RA combination products have been studied in the DUAL program and Laxilan program. Clinical trial data has showed insulin/GLP-1RA fixed-ratio combinations are superior at reducing HbA1c with weight neutrality or weight loss rather than weight gain, as well as reduced hypoglycemia rates compared with basal insulin highlighting the great potential of these agents.
Authors and Affiliations
Sandeep Chaudhary, Khalid Shaikh
Keywords
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