GLP-1 Receptor Agonists as Add-On Improve HbA1c
Reduction in HbA1c with both lixisenatide, glulisine; less hypoglycemia with lixisenatide
(HealthDay News) -- Lixisenatide and glulisine as add-on to basal insulin result in a reduction in glycated hemoglobin (HbA1c) levels in patients with type 2 diabetes, according to a study published online in Diabetes Care.
Julio Rosenstock, M.D., from the Dallas Diabetes and Endocrine Center at Medical City, and colleagues randomized overweight patients with type 2 diabetes inadequately controlled on basal insulin glargine with or without 1 to 3 oral antidiabetic agents. If HbA1c levels remained ≥7 to ≤9% after 12 weeks of glargine optimization, participants were randomized to lixisenatide once daily or insulin glulisine given once or 3 times daily.
The researchers found that the baseline characteristics were similar between the groups (298 patients). There was improvement in HbA1c seen with glargine optimization (from 8.5 to 7.9%), which further improved to 7.2, 7.2, and 7.0%, respectively, with lixisenatide and glulisine once daily and 3 times daily. All study coprimary end points were met. Lixisenatide versus glulisine patients had less symptomatic hypoglycemia and lower body weight. There were more gastrointestinal events with lixisenatide.
"Short-acting glucagon-like peptide-1 receptor agonists as add-on to basal insulin may become a preferred treatment intensification option, attaining meaningful glycemic targets with fewer hypoglycemic events without weight gain versus basal-plus or basal-bolus in uncontrolled basal insulin-treated type 2 diabetes," the authors write.
Several authors disclosed financial ties to pharmaceutical companies, including Sanofi, which manufactures lixisenatide and sponsored the GetGoal Duo-2 trial.
1. Prandial Options to Advance Basal Insulin Glargine Therapy: Testing Lixisenatide Plus Basal Insulin Versus Insulin Glulisine Either as Basal-Plus or Basal-Bolus in Type 2 Diabetes: The GetGoal Duo-2 Trial. Diabetes Care 2016 Jun; dc160014. doi: 10.2337/dc16-0014.