Fixed versus flexible combination of GLP-1 receptor agonists with basal insulin in type 2 diabetes: A retrospective multicentre comparative effectiveness study

Diabetes, Obesity & Metabolism
Mario Luca MorieriGian Paolo Fadini

Abstract

The combination of basal insulin (BI) and GLP-1 receptor agonists (GLP-1RAs) is a rational and effective therapy for patients with uncontrolled type 2 diabetes (T2D). We compared the effectiveness of fixed and flexible BI/GLP-1RA combinations using routinely accumulated clinical data. This was a retrospective, multicentre, real-world study concerning T2D patients initiating a fixed or flexible BI/GLP-1RA combination (NCT03959865). The primary endpoint was change in HbA1c. Secondary endpoints were changes in body weight, fasting plasma glucose (FPG) and systolic blood pressure (SBP). Confounding was addressed by propensity score matching (PSM) or multivariable adjustment (MVA). A total of 609 patients were included in the study, 131 in the fixed group and 478 in the flexible group. The two groups differed in terms of diabetes duration, body weight and concomitant medications. After 5.7 months, observed HbA1c reductions were 0.6% and 0.8%, and body weight reductions were 2.8 kg and 1.2 kg in the flexible and fixed groups, respectively. Following PSM, HbA1c declined similarly in the two groups, whereas reduction in body weight was significantly in favour of the flexible combination. Findings were robust in sensitivity analyses, wi...Continue Reading

Associated Clinical Trials

References

May 28, 2010·Diabetes Research and Clinical Practice·Wenying YangPhilip D Home
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Dec 10, 2017·The Lancet. Diabetes & Endocrinology·M Angelyn BethelUNKNOWN EXSCEL Study Group
Jan 25, 2018·Diabetes, Obesity & Metabolism·Sudesna ChatterjeeKamlesh Khunti
Mar 9, 2018·Diabetes, Obesity & Metabolism·Gian Paolo FadiniUNKNOWN DARWIN-T2D network
Aug 24, 2018·Diabetes, Obesity & Metabolism·Gian Paolo FadiniUNKNOWN DARWIN-T2D Network
Jan 6, 2019·Advances in Therapy·Leigh PerreaultEric Johnson
Jan 22, 2019·Lancet·Hertzel C GersteinRury R Holman

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Citations

Apr 18, 2020·The Journal of Clinical Endocrinology and Metabolism·Mario Luca MorieriGian Paolo Fadini
Oct 27, 2020·Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders·Luciano ZenariAnnunziata Lapolla
Feb 7, 2021·Diabetes Research and Clinical Practice·Benedetta Maria BonoraGian Paolo Fadini
Nov 19, 2020·Diabetes, Metabolic Syndrome and Obesity : Targets and Therapy·Mario Luca MorieriGian Paolo Fadini

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Clinical Trials Mentioned

NCT03959865

Software Mentioned

IdegLira
MVA
ORBIT
SAS

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