Comparing Insulin Regimens in Uncontrolled Type 2 Diabetes

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 (HbA_1c) 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 HbA_1c 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 HbA_1c 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.