Rates of hypoglycaemia are lower in patients treated with insulin degludec/liraglutide (IDegLira) than with IDeg or insulin glargine, regardless of the hypoglycaemia definition used.

Authors:
Dr Paul Norwood, MD
Dr Paul Norwood, MD
University of California at San Francisco
Associate Clinical Professor of Medicine at UC San Francisco
Diabetes, cholesterol, hypertension,
Fresno, CA | United States
Roger Chen
Roger Chen
University of California at Berkeley
United States
Elmar Jaeckel
Elmar Jaeckel
Hannover Medical School
Germany
Ildiko Lingvay
Ildiko Lingvay
University of Texas Southwestern Medical Center
Simon Heller
Simon Heller
University of Sheffield
United Kingdom

Diabetes Obes Metab 2017 11 10;19(11):1562-1569. Epub 2017 Jul 10.

University of Sheffield, Sheffield, UK.

Aims: To re-analyse, using a series of alternative hypoglycaemia definitions, the data from 2 trials, DUAL I and V, in which the once-daily, fixed ratio combination of insulin degludec/liraglutide (IDegLira) was compared with basal insulin therapy.

Material And Methods: Post hoc analyses of the DUAL I (patients uncontrolled on oral antidiabetic drugs) and DUAL V (patients uncontrolled on insulin glargine (IGlar) U100) trials were carried out using different definitions of hypoglycaemia and according to whether treatments were administered in the morning or afternoon. Rates of hypoglycaemia for the definitions of confirmed and American Diabetes Association (ADA)-documented symptomatic hypoglycaemia were compared according to age, gender and body mass index (BMI).

Results: Although hypoglycaemia rates differed according to the alternative hypoglycaemia definitions, rates were consistently lower with IDegLira vs insulin degludec (IDeg) and IGlar U100. Despite glycated haemoglobin concentrations being lower with IDegLira at end of treatment, confirmed and nocturnal-confirmed hypoglycaemia rates were lower for IDegLira vs IDeg and IGlar U100, irrespective of dosing time. The definitions of confirmed and ADA-documented symptomatic hypoglycaemia did not have a significant effect on the treatment difference between IDegLira and IDeg, liraglutide or IGlar U100 when further assessed by baseline age, gender and BMI.

Conclusions: Treatment with IDegLira, vs IDeg and IGlar U100, resulted in lower rates of hypoglycaemia regardless of dosing time and definition of hypoglycaemia used. The choice of hypoglycaemia definition did not influence the results of analyses when stratified by age, sex and BMI.

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http://doi.wiley.com/10.1111/dom.12972
Publisher Site
http://dx.doi.org/10.1111/dom.12972DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5655847PMC

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November 2017
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References

(Supplied by CrossRef)
IDeglira is efficacious across baseline HbA1c categories in subjects with type 2 diabetes uncontrolled on SU, GLP-1RA or insulin glargine: analyses from completed phase 3b trials
Sorli et al.
Diabetes 2016

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