Abstract
IntroductionThe aim of the present study was to describe clinical outcomes in a real-world population of Swiss patients with long-standing, poorly controlled type 2 diabetes after switching to IDegLira [a combination of insulin degludec (IDeg) and liraglutide (Lira)].MethodsThis was a prospective, open-label, single-center observational follow-up at the Cabinet Medical de Diabétologie, Lausanne, Switzerland, of 61 patients [HbA1c 9.2% (77 mmol/mol) and 56.1 U total insulin] initiated with IDegLira at 20 dose steps (20 U IDeg/0.72 mg Lira), except in insulin-naïve patients who began treatment at 16 dose steps. Thereafter, the dose was titrated by four dose steps once weekly, according to individualized fasting blood glucose targets. Information about glycemic control, total insulin dose, weight, and blood pressure, along with any adverse events, was collected from medical records and patient reports during clinic visits at baseline, 3 months, and end of follow-up.ResultsOver 6 months of follow-up, mean HbA1c improved (decrease of 1.7%) to 7.5% with concomitant weight loss. Switching to IDegLira resulted in a lower (−14.6 U) total insulin dose compared with baseline for those patients previously on insulin. There were no episodes of severe hypoglycemia during treatment with IDegLira. There were small decreases in both mean systolic and mean diastolic blood pressure with IDegLira. Six patients discontinued treatment early because of adverse gastrointestinal events with IDegLira.ConclusionSwitching to IDegLira, mostly from regimens using insulin in conjunction with oral antidiabetic medications in a real-world population of patients with type 2 diabetes, resulted in improved glucose control with a lower insulin dose and weight loss.Electronic supplementary materialThe online version of this article (doi:10.1007/s13300-017-0234-y) contains supplementary material, which is available to authorized users.
Highlights
The aim of the present study was to describe clinical outcomes in a real-world population of Swiss patients with long-standing, poorly controlled type 2 diabetes after switching to IDegLira [a combination of insulin degludec (IDeg) and liraglutide (Lira)]
Almost all patients (n = 56, 91.8%) had been using insulin, and the population could be characterized as very overweight and in poor glycemic control
Twelve (19.7%) patients did not use any other therapy besides IDegLira for their diabetes
Summary
The aim of the present study was to describe clinical outcomes in a real-world population of Swiss patients with long-standing, poorly controlled type 2 diabetes after switching to IDegLira [a combination of insulin degludec (IDeg) and liraglutide (Lira)]. Information about glycemic control, total insulin dose, weight, and blood pressure, along with any adverse events, was collected from medical records and patient reports during clinic visits at baseline, 3 months, and end of follow-up. Conclusion: Switching to IDegLira, mostly from regimens using insulin in conjunction with oral antidiabetic medications in a realworld population of patients with type 2 diabetes, resulted in improved glucose control with a lower insulin dose and weight loss. Liraglutide is a human GLP-1 analogue given once daily; it stimulates insulin secretion and lowers glucagon secretion in a glucose-dependent fashion, posing a low risk of hypoglycemia while helping to control both fasting and post-meal glucose levels [7]
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