Impact of Type 2 Diabetes Duration on Response to iGlarLixi vs. iGlar: A Subanalysis of LixiLan-L

Abstract

Shorter-acting GLP-1RAs like lixisenatide have insulin-independent effects, which may benefit patients (pts) with longer type 2 diabetes (T2D) duration and more β-cell dysfunction. We assessed the effects of insulin glargine (iGlar) vs. fixed-ratio iGlar plus lixisenatide (iGlarLixi) by T2D duration in the LixiLan-L trial (n=736). HbA1C, weight, insulin dose change (BL-Wk 30) and hypoglycemia were analyzed in pts divided in quartiles by recorded baseline (BL) T2D duration (<7.3; 7.3-<10.7; 10.7–15.7; >15.7 yrs). Pts were also grouped by BL insulin dose (may relate inversely to β-cell function). BL HbA1c was higher in long-duration quartiles but similar with iGlarLixi vs iGlar. iGlarLixi reduced HbA1C more vs. iGlar across duration quartiles (Figure 1). The difference was greater in pts in the longest-duration quartile (LS mean difference [SE] -0.62 [0.13]; p<0.0001). In both treatment groups, pts in the shortest-duration quartile had the greatest insulin dose change (BL-Wk 30). The difference in hypoglycemia (iGlarLixi vs. iGlar) was greatest in pts in the longest-duration quartile (3.3 vs. 6.9 events/pt-yr; p<0.0001). In pts grouped by T2D duration and insulin dose, those with both a long duration (>15.7 yrs) and high dose (>42 U) showed the greatest difference in HbA1C lowering with iGlarLixi vs. iGlar. In LixiLan-L, iGlarLixi lowered HbA1C more vs. iGlar regardless of T2D duration, with the greatest difference in those with the longest duration.