Initiating Titratable Fixed-Ratio Combinations of Basal Insulin Analogs and Glucagon-Like Peptide-1 Receptor Agonists: What You Need to Know

Neil Skolnik; Debbie Hinnen; Yan Kiriakov; Melissa L Magwire; John R White Jr

doi:10.2337/cd17-0048

Initiating Titratable Fixed-Ratio Combinations of Basal Insulin Analogs and Glucagon-Like Peptide-1 Receptor Agonists: What You Need to Know

Clin Diabetes. 2018 Apr;36(2):174-182. doi: 10.2337/cd17-0048.

Authors

Neil Skolnik¹, Debbie Hinnen², Yan Kiriakov¹, Melissa L Magwire³, John R White Jr⁴

Affiliations

¹ Abington Jefferson Health, Abington, PA.
² Memorial Hospital Diabetes Center, Colorado Springs, CO.
³ Shawnee Mission Health, Merriam, KS.
⁴ Washington State University, Spokane, WA.

Abstract

IN BRIEF Titratable fixed-ratio combinations (FRCs) of a basal insulin and a glucagon-like peptide-1 (GLP-1) receptor agonist are new therapeutic options for people with type 2 diabetes. Two FRCs-insulin degludec/liraglutide and insulin glargine/lixisenatide-have been approved for use in the United States. The two components in these FRCs target different aspects of diabetes pathophysiology, working in a complementary manner to decrease blood glucose while mitigating the side effects associated with each component (hypoglycemia and weight gain with insulin and gastrointestinal side effects with GLP-1 receptor agonists). This article reviews these products and key considerations for their use.