GLP-1 receptor agonists for diabetes: a review of the cardiovascular, kidney and mortality outcomes

Can iGlarLixi improve blood glucose control in patients receiving basal insulin?


Posted by Medivizor on May 24, 2020 in Diabetes mellitus |

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In a nutshell

This study looked at whether iGlarLixi (Soliqua), a combination of long-acting insulin glargine (Lantus) and lixisenatide (Lyxumia), can improve glucose control for patients with type 2 diabetes (T2D) uncontrolled with long-acting insulin alone. It found that iGlarLixi improved overall and after-meal blood sugar control compared to insulin alone.

Some background

T2D is a disease in which the body does not respond well to the hormone insulin, leading to high levels of glucose (sugar) in the blood. One treatment option for T2D is insulin injections. Basal insulin is a type of insulin that acts for an extended period in the body, and may only need to be used once a day. Insulin glargine is one type of basal insulin. However, basal insulins are often not enough to control the rise in glucose levels following meals. One treatment option is to use both a basal insulin and a short-acting insulin around meals. However, this can cause side effects including low blood sugar (hypoglycemia) and weight gain.

Lixisenatide is another option to improve the body’s insulin response around meals. Lixisenatide acts like the GLP-1 hormone, which is released by the gut. Lixisenatide helps the pancreas to release insulin when glucose levels are high.

iGlarLixi combines insulin glargine and lixisenatide into a single daily injection. It is unclear whether iGlarLixi can improve glucose control compared to insulin alone.

Methods & findings

This study reanalyzed results from 736 patients with T2D who were using basal insulin. There was a six-week phase during which patients were switched to insulin glargine and the dose was stabilized. Half of the patients were randomly assigned to continue with insulin glargine, and the other half received iGlarLixi. The medication was taken daily before breakfast. The patients were followed for 12 weeks.

Glycated hemoglobin (HbA1c) is a measure of glucose control over the previous two to three months. 41.7% of patients had good glucose control when a meal had not been eaten recently (below 140 mg/dL), but still had high HbA1c (over 7.0%). These patients were said to have residual high blood sugar.

After 12 weeks, significantly fewer patients in the iGlarLixi group had residual high blood glucose (33.1% vs. 51.5%). This difference remained significant at 30 weeks (23.8% vs. 47.1%). Significantly more patients taking iGlarLixi reached the targets for both HbA1c and fasting glucose (50.3% vs. 27.4%).

The bottom line

This study found that iGlarLixi reduced the number of patients with T2D who had residual high blood sugar.

The fine print

This study was funded by Sanofi, the manufacturer of Soliqua.

Published By :

Diabetes, Obesity and Metabolism

Original Title :

iGlarLixi effectively reduces residual hyperglycemia in patients with type 2 diabetes on basal insulin: a post hoc analysis from the LixiLan-L study.

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