Comparison of efficacy and safety of insulin degludec/liraglutide and insulin glargine U-100/lixisenatide in individuals with type 2 diabetes mellitus using professional continuous glucose monitoring

J Diabetes Investig. 2024 May;15(5):598-607. doi: 10.1111/jdi.14151. Epub 2024 Jan 23.

Abstract

Aim/introduction: Insulin glargine U100/lixisenatide and insulin degludec/liraglutide are fixed-ratio combinations containing basal insulin and a glucagon-like peptide-1 receptor agonist capable of reducing both fasting and postprandial blood glucose levels with a single formulation. This study aimed to compare the time in range (TIR) and the time below range (TBR) level 1 using professional continuous glucose monitoring and to establish criteria for the differential use of the fixed-ratio combinations.

Materials and methods: Thirty-six outpatients with type 2 diabetes mellitus (24 men and 12 women; average age, 62.1 years) were randomly assigned to the groups. At 0 and 18 weeks, a device was worn to compare the TIR and TBR level 1. The correlation between the C-peptide index at baseline and TIR at 18 weeks was assessed.

Results: The TIR and TBR level 1 showed no significant differences between the two groups. Both groups showed significant positive correlations between the C-peptide index and the TIR (P = 0.002, r = 0.679; P = 0.002, r = 0.681, respectively). The changes in glycemic variability, therapeutic indices, and body mass index were not significantly different among the groups (P > 0.05). The receiver operating curve analysis revealed that the cut-off values of the C-peptide index to achieve TIR of >70% at 18 weeks were 1.258 (sensitivity, 77.8%; specificity, 100%) and 1.099 (sensitivity, 57.1%; specificity, 90.9%) in the insulin glargine U100/lixisenatide and insulin degludec/liraglutide groups, respectively.

Conclusions: A TIR of >70% was achieved for both fixed-ratio combinations without significant differences.

Keywords: C‐peptide index; IDegLira; IGlarLixi.

Publication types

  • Randomized Controlled Trial
  • Comparative Study

MeSH terms

  • Aged
  • Blood Glucose Self-Monitoring / methods
  • Blood Glucose* / analysis
  • Blood Glucose* / drug effects
  • Continuous Glucose Monitoring
  • Diabetes Mellitus, Type 2* / blood
  • Diabetes Mellitus, Type 2* / drug therapy
  • Drug Combinations
  • Female
  • Glucagon-Like Peptide-2 Receptor*
  • Humans
  • Hypoglycemic Agents* / therapeutic use
  • Insulin Glargine* / administration & dosage
  • Insulin Glargine* / therapeutic use
  • Insulin, Long-Acting* / therapeutic use
  • Liraglutide* / therapeutic use
  • Male
  • Middle Aged
  • Peptides / therapeutic use
  • Treatment Outcome

Substances

  • Insulin Glargine
  • Liraglutide
  • Insulin, Long-Acting
  • Hypoglycemic Agents
  • insulin degludec
  • Blood Glucose
  • Peptides
  • lixisenatide
  • Drug Combinations
  • Glucagon-Like Peptide-2 Receptor