Combination of basal insulin and GLP-1 receptor agonist: is this the end of basal insulin alone in the treatment of type 2 diabetes?

Table 1 Studies evaluating the efficacy of IDegLira and IGlarLixi in patients with diabetes mellitus type 2 inadequately controlled with oral medication and insulin naive

Study	DUAL-1			LixiLan-O
Study	IDegLira	Degludec	Liraglutide	IGlarLixi	Glargine U100	Lixisenatide
Duration	26 weeks			30 weeks
Population	1663 T2DM adults, A1c 8.3 ± 0.9; BMI 31.2 ± 4.8 kg/m², metformin ± pioglitazone			1170 T2DM adults, A1c 8.2 ± 0.7; BMI 31.7 ± 4.4 kg/m²; metformin ± pioglitazone
Mean insulin dose (final)	38 ± 13	53 ± 28		39 ± 14	40 ± 14
ΔA1c	− 1.9 ± 1.1	− 1.4 ± 1.0	− 1.3 ± 1.1	− 1.6 ± 0.1	− 1.3 ± 0.1	− 0.8 ± 0.1
Final A1c (week 30)	6.4 ± 1.0	6.9 ± 1.1	7.0 ± 1.2	6.5 ± 0.8	6.8 ± 0.8	7.3 ± 0.9
Δ body weight (kg)	− 0.5 ± 3.5	+ 1.6 ± 4.0	− 3.0 ± 3.5	− 0.3 ± 0.2	+ 1.1 ± 0.2	− 2.3 ± 0.3
% A1c < 7%	81	65	60	74	59	33
%A1c < 7% without weight gain	46	21	54	43	25	28
%A1c < 7% without hypoglycemia	60	41	58	53	44	30
%A1c < 7% without weight gain or hypoglycemia	36	14	52	32	19	26
Hypoglycemia (%)^a	32	39	7	26	24	6

^aDifferent definitions for hypoglycaemia were used in the two studies. For the DUAL I trial, confirmed hypoglycaemia was defined as the occurrence of episodes requiring assistance (severe), or episodes in which plasma glucose concentration (determined from self-monitored blood glucose) was less than 56 mg/dL, irrespective of symptoms. For the LixiLan-O trial, documented symptomatic hypoglycemia was defined as typical symptoms of hypoglycaemia accompanied by a measured plasma glucose concentration of #70 mg/dL

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