Comparing Insulin Regimens in Uncontrolled Type 2 Diabetes

Researchers compare once-daily injection of degludec and liraglutide versus once-daily injection of glargine.

A recent study compared the efficacy of insulin regimens for uncontrolled type 2 diabetes patients, who experience difficulties achieving optimal glucose control.

Approximately less than one-third of patients treated with basal insulin (glargine) reach a glycated hemoglobin (HbA1c) level less than 7%.

A study published in JAMA enrolled 557 patients with uncontrolled diabetes into a 26-week trial conducted in 10 countries at 75 centers.

Patients were randomized to receive a once-daily injection of the combination of degludec and liraglutide (n = 278) or a once-daily injection of glargine (n = 279).

The results of the study showed that HbA1c level reduction was greater in the combination of degludec and liraglutide compared with glargine. Furthermore, it was able to meet the criteria for non-inferiority.

A secondary analysis showed a greater HbA1c level reduction with degludec and liraglutide. Additionally, the combination insulin regimens were found to have an association with weight loss compared with weight gain in patients given glargine, and a lower rate of hypoglycemia.

The overall and serious adverse event rates were similar in the 2 groups, but there were more nonserious gastrointestinal adverse events reported for the group injected with degludec and liraglutide.

“Further research is indicated to evaluate the durability of the effects of degludec/liraglutide in longer-term studies, in clinical practice, and to assess whether patients and physicians consider degludec/liraglutide a suitable treatment option to overcome barriers to treatment intensification,” the authors wrote.