Insulin Combination Outperforms Glargine in Type 2 Diabetes

Degludec/liraglutide is noninferior—and may even be superior—to insulin glargine for the treatment of patients with uncontrolled type 2 diabetes, according to a recent study.

 

In order to test the effectiveness of degludec/liraglutide in patients already being treated with insulin glargine and metformin, researchers conducted a Phase 3, multinational, multicernter, 26-week, randomized, open-label, 2-group, treat-to-target trial of 557 patients with uncontrolled diabetes.
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Patients were randomized to either degludec/liraglutide or glargine, with twice-weekly titration to a glucose target of 72 to 90 mg/dL.

Overall, mean HbA1c levels decreased by 1.81% in patients taking degludec/liraglutide and by 1.13% in those taking glargine. Degludec/liraglutide was also associated with a weight loss of 1.4 kg vs a weight gain of 1.8 kg for glargine. Patients taking degludec/liraglutide had fewer hypoglycemic episodes than those taking glargine, and the number of serious adverse events were similar between the 2 options.

“Among patients with uncontrolled type 2 diabetes taking glargine and metformin, treatment with degludec/liraglutide compared with up-titration of glargine resulted in noninferior HbA1c levels, with secondary analyses indicating greater HbA1c level reduction after 26 weeks of treatment. Further studies are needed to assess longer-term efficacy and safety,” they concluded.

—Michael Potts

Reference:

Lingvay I, Manghi FP, Hernandez PG, et al. Effect of insulin glargine up-titration vs insulin degludec/liraglutide on glycated hemoglobin levels in patients with uncontrolled type 2 diabetes. JAMA. 2016;315(9):898-907.