title: Pharmacokinetic evaluation of fixed-ratio combination of insulin degludec and liraglutide in the treatment of type 2 diabetes.
abstract: BACKGROUND
  Type 2 diabetes is a complex disease requiring individualized and often multi-faceted treatment plans. Balancing glycemic control with adverse medication side effects can be challenging. Combination therapy of basal insulin and GLP-1 receptor agonist therapy appears to provide a balance between glycemic efficacy, hypoglycemia and weight gain.
  
  
  METHODS
  Available pharmacokinetic data, clinical trials and abstracts regarding fixed-ratio combination of insulin degludec and liraglutide were reviewed. Literature was searched from PubMed and available abstracts using the search term IDegLira up to June 2016.
  
  
  CONCLUSIONS
  Fixed-ratio combination of insulin degludec and liraglutide is associated with sustained glucose-lowering effects as assessed by HbA1c reduction. Overall, hypoglycemia is reduced and weight loss is observed compared to basal insulin alone. There is no significant increase in gastrointestinal side-effects, including nausea compared to non-glucagon-like peptide-1 receptor agonists. Pen injector delivery and dose-step titration allow for individualized therapy intensification. Combined treatment for type 2 diabetes with degludec and liraglutide therapy provides complementary therapeutic efficacy in the treatment of individuals with type 2 diabetes.
authors.affiliation: a Division of Endocrinology, Diabetes and Metabolism , University of Maryland School of Medicine , Baltimore , MD , USA.
authors.forename: Elizabeth Mary
authors.initials: EM
authors.lastname: Lamos
authors.affiliation: b Department of Medicine , University of Maryland School of Medicine , Baltimore , MD , USA.
authors.forename: Stephen N
authors.initials: SN
authors.lastname: Davis
mesh_terms: D000818:Animals; D001786:Blood Glucose / Q000187:drug effects; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D004338:Drug Combinations; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D049528:Insulin, Long-Acting / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D000069450:Liraglutide / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D015430:Weight Gain / Q000187:drug effects
chemical_list: D001786:Blood Glucose; D004338:Drug Combinations; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D049528:Insulin, Long-Acting; D000069450:Liraglutide; C571886:insulin degludec
keywords: Degludec; IDegLira; liraglutide; pharmacokinetics