TY - JOUR
T1 - Clinical Considerations When Initiating and Titrating Insulin Degludec/Liraglutide (IDegLira) in People with Type 2 Diabetes
AU - Harris, Stewart
AU - Abrahamson, Martin J.
AU - Ceriello, Antonio
AU - Charpentier, Guillaume
AU - Evans, Marc
AU - Lehmann, Roger
AU - Liebl, Andreas
AU - Linjawi, Sultan
AU - Holt, Richard I.G.
AU - Hosszúfalusi, Nóra
AU - Rutten, Guy
AU - Vilsbøll, Tina
N1 - Funding Information:
The authors thank Kerry Guest, Ph.D., and Germanicus Hansa-Wilkinson, MSc (Watermeadow Medical, an Ashfield Company, part of UDG Healthcare plc.), for providing medical writing and editorial support. This support was funded by Novo Nordisk.
Funding Information:
The authors thank Kerry Guest, Ph.D., and Germanicus Hansa-Wilkinson, MSc (Watermeadow Medical, an Ashfield Company, part of UDG Healthcare plc.), for providing medical writing and editorial support. This support was funded by Novo Nordisk.
Publisher Copyright:
© 2020, The Author(s).
PY - 2020/2/1
Y1 - 2020/2/1
N2 - Therapeutic inertia is a substantial obstacle to the initiation of insulin therapy in people with uncontrolled type 2 diabetes (T2D). This effect has in part been perpetuated by concerns over the impact of a burdensome regimen and the increased risk of hypoglycemia and body weight gain often associated with insulin use. An effective, yet simple, less burdensome regimen with a lower risk of body weight gain and hypoglycemia compared with an insulin-only regimen, may help to address these concerns more effectively. We review the available clinical and real-world data on IDegLira, a once-daily, injectable, fixed-ratio combination of insulin degludec (degludec) and the glucagon-like peptide-1 receptor agonist (GLP-1RA) liraglutide, in people with T2D. Evidence from the comprehensive DUAL clinical trial program suggests an advantage of IDegLira over traditional insulin therapies in a number of clinical outcomes, including maintenance of glycemic control, achievement of glycemic targets, reducing the risk of hypoglycemia, and body weight loss. These findings were demonstrated in participants with T2D irrespective of prior GLP-1RA and insulin use. Furthermore, the individual components of IDegLira have confirmed safety (degludec) or significant benefit in terms of improvement of cardiovascular risk (liraglutide). As an injectable therapy that is simple to titrate, IDegLira has the potential to optimize the ability to achieve relevant glycemic targets, and offers a suitable treatment option for people with T2D requiring insulin therapy who are at risk of hypoglycemia or weight gain.
AB - Therapeutic inertia is a substantial obstacle to the initiation of insulin therapy in people with uncontrolled type 2 diabetes (T2D). This effect has in part been perpetuated by concerns over the impact of a burdensome regimen and the increased risk of hypoglycemia and body weight gain often associated with insulin use. An effective, yet simple, less burdensome regimen with a lower risk of body weight gain and hypoglycemia compared with an insulin-only regimen, may help to address these concerns more effectively. We review the available clinical and real-world data on IDegLira, a once-daily, injectable, fixed-ratio combination of insulin degludec (degludec) and the glucagon-like peptide-1 receptor agonist (GLP-1RA) liraglutide, in people with T2D. Evidence from the comprehensive DUAL clinical trial program suggests an advantage of IDegLira over traditional insulin therapies in a number of clinical outcomes, including maintenance of glycemic control, achievement of glycemic targets, reducing the risk of hypoglycemia, and body weight loss. These findings were demonstrated in participants with T2D irrespective of prior GLP-1RA and insulin use. Furthermore, the individual components of IDegLira have confirmed safety (degludec) or significant benefit in terms of improvement of cardiovascular risk (liraglutide). As an injectable therapy that is simple to titrate, IDegLira has the potential to optimize the ability to achieve relevant glycemic targets, and offers a suitable treatment option for people with T2D requiring insulin therapy who are at risk of hypoglycemia or weight gain.
KW - Diabetes Mellitus, Type 2/drug therapy
KW - Drug Combinations
KW - Humans
KW - Hypoglycemic Agents/administration & dosage
KW - Insulin, Long-Acting/administration & dosage
KW - Liraglutide/administration & dosage
UR - http://www.scopus.com/inward/record.url?scp=85078247530&partnerID=8YFLogxK
U2 - 10.1007/s40265-019-01245-3
DO - 10.1007/s40265-019-01245-3
M3 - Review article
C2 - 31960258
AN - SCOPUS:85078247530
SN - 0012-6667
VL - 80
SP - 147
EP - 165
JO - Drugs
JF - Drugs
IS - 2
ER -