title: Comparison of insulin glargine and liraglutide added to oral agents in patients with poorly controlled type 2 diabetes.
abstract: OBJECTIVE
  To compare safety and efficacy of insulin glargine and liraglutide in patients with type 2 diabetes (T2DM).
  
  
  METHODS
  This randomized, multinational, open-label trial included subjects treated for T2DM with metformin ± sulphonylurea, who had glycated haemoglobin (HbA1c) levels of 7.5-12%. Subjects were assigned to 24 weeks of insulin glargine, titrated to target fasting plasma glucose of 4.0-5.5 mmol/L or liraglutide, escalated to the highest approved clinical dose of 1.8 mg daily. The trial was powered to detect superiority of glargine over liraglutide in percentage of people reaching HbA1c <7%.
  
  
  RESULTS
  The mean [standard deviation (s.d.)] age of the participants was 57 (9) years, the duration of diabetes was 9 (6) years, body mass index was 31.9 (4.2) kg/m(2) and HbA1c level was 9.0 (1.1)%. Equal numbers (n = 489) were allocated to glargine and liraglutide. Similar numbers of subjects in both groups attained an HbA1c level of <7% (48.4 vs. 45.9%); therefore, superiority of glargine over liraglutide was not observed (p = 0.44). Subjects treated with glargine had greater reductions of HbA1c [-1.94% (0.05) and -1.79% (0.05); p = 0.019] and fasting plasma glucose [6.2 (1.6) and 7.9 (2.2) mmol/L; p < 0.001] than those receiving liraglutide. The liraglutide group reported a greater number of gastrointestinal treatment-emergent adverse events (p < 0.001). The mean (s.d.) weight change was +2.0 (4.0) kg for glargine and -3.0 (3.6) kg for liraglutide (p < 0.001). Symptomatic hypoglycaemia was more common with glargine (p < 0.001). A greater number of subjects in the liraglutide arm withdrew as a result of adverse events (p < 0.001).
  
  
  CONCLUSIONS
  Adding either insulin glargine or liraglutide to subjects with poorly controlled T2DM reduces HbA1c substantially, with nearly half of subjects reaching target levels of 7%.
authors.affiliation: Department of Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
authors.forename: D
authors.initials: D
authors.lastname: D'Alessio
authors.forename: H-U
authors.initials: HU
authors.lastname: Häring
authors.forename: B
authors.initials: B
authors.lastname: Charbonnel
authors.forename: P
authors.initials: P
authors.lastname: de Pablos-Velasco
authors.forename: C
authors.initials: C
authors.lastname: Candelas
authors.forename: M-P
authors.initials: MP
authors.lastname: Dain
authors.forename: M
authors.initials: M
authors.lastname: Vincent
authors.forename: V
authors.initials: V
authors.lastname: Pilorget
authors.forename: H
authors.initials: H
authors.lastname: Yki-Järvinen
mesh_terms: D000284:Administration, Oral; D000368:Aged; D001786:Blood Glucose / Q000187:drug effects* / Q000378:metabolism; D015992:Body Mass Index; D001835:Body Weight; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D052216:Glucagon-Like Peptide 1 / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006442:Glycated Hemoglobin / Q000187:drug effects / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000069036:Insulin Glargine; D049528:Insulin, Long-Acting / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D007391:International Cooperation; D000069450:Liraglutide; D008297:Male; D008687:Metformin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D052216:Glucagon-Like Peptide 1; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D000069036:Insulin Glargine; D049528:Insulin, Long-Acting; D000069450:Liraglutide; D008687:Metformin; C517652:hemoglobin A1c protein, human
keywords: insulin glargine; liraglutide; type 2 diabetes