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Once-daily liraglutide may intensify insulin treatment in type 2 diabetes
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In patients whose type 2 diabetes is not sufficiently controlled by insulin degludec and metformin, the addition of once-daily liraglutide provides better glycemic control and weight-loss benefits than the addition of once-daily insulin aspart, recent study results found.
“Thus, this therapeutic option should be considered when basal insulin therapy requires intensification,” the researchers wrote.
The multinational (119 sites in 12 countries) phase 3b, open-label, randomized, treat-to-target study compared the addition of once-daily liraglutide (Victoza, Novo Nordisk) with the addition of once-daily insulin aspart (NovoLog FlexPen, Novo Nordisk) to an existing regimen of once-daily insulin degludec and metformin. All patients continued taking metformin during the trial, which lasted for 28 days. There were three parallel arms in the study: two were randomized (insulin degludec and liraglutide, n=88; insulin degludec and insulin aspart, n=89) and one was not randomized (insulin degludec and metformin, n=236).
The researchers found that insulin degludec and liraglutide decreased HbA1c significantly more than insulin degludec and insulin aspart (–0.74% vs. –0.39%), with an estimated treatment difference of –0.32% (95% CI, –0.53 to –0.12). More insulin degludec and liraglutide (49.4%) than insulin degludec and insulin aspart (7.2%) patients achieved HbA1c <7% without hypoglycemia or severe hypoglycemia, and without weight gain. Participants in the insulin degludec and liraglutide arm had significantly less confirmed and nocturnal confirmed hypoglycemia, and statistically more weight loss (−2.8 kg) vs. those in the insulin degludec and insulin aspart arm (0.9 kg, P<.0001).
With the exception of more gastrointestinal side effects seen with insulin degludec and liraglutide, there were no differences in safety.
According to the researchers, these findings could represent a valid option for insulin intensification when basal insulin is not sufficient for glycemic control.
Disclosure: Many of the researchers have various financial ties with Novo Nordisk. Please see the full study for a complete list of relevant financial disclosures.
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