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 2 Studies evaluating the efficacy of IDegLira and IGlarLixi in patients with diabetes mellitus type 2 inadequately controlled with basal insulin

Study	DUAL-2		DUAL-5		LixiLan L
Study	IDegLira	Degludec	IDegLira	Glargine U100	IGlarLixi	Glargine U100
Duration	26 weeks		26 weeks		30 weeks
Population	413 T2DM adults, A1c 8.7 ± 0.7%, basal insulin and metformin ± sulphonylureas or glinides; mean basal insulin dose at baseline 29 ± 8		557 T2DM, A1c 8.4/8.2 ± 0.9%, basal insulin (glargine) and metformin; mean basal insulin dose at baseline 31 ± 10		736 T2DM adults, A1c 8.1 ± 0.7%, basal insulin and metformin ± OAD; mean basal insulin dose at baseline 35 ± 9
Mean insulin dose (final)	45	45	41	66	47	47
ΔA1c	− 1.9	− 0.9	− 1.8	− 1.1	− 1.1	− 0.6
Final A1c (week 30)	6.9	8.0	6.6	7.1	6.9	7.5
Δ body weight (kg)	− 2.7	0.0	− 1.4	+ 1.8	− 0.7	0.7
% A1c < 7%	60	23	72	47	34	13
A1c < 7% without weight gain (%)	NA	NA	50	20	34	13
A1c < 7% without hypoglycemia (%)	NA	NA	54	29	32	19
A1c < 7% without weight gain or hypoglycemia (%)	40	8	39	12	20	9
Hypoglycemia (%)^a	24	25	28	49	40	42

^aDifferent definitions for hypoglycaemia were used in the two studies. For the DUAL 2 and 5 trials, 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-L 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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