title: A Fixed Ratio Combination of Insulin Degludec and Liraglutide (IDegLira) Reduces Glycemic Fluctuation and Brings More Patients with Type 2 Diabetes Within Blood Glucose Target Ranges.
abstract: Reducing glycemic fluctuation is important for optimal diabetes management. This post hoc analysis examined glycemic fluctuations and the proportion of subjects achieving recommended blood glucose targets with the fixed ratio combination of insulin degludec and liraglutide (IDegLira) compared to insulin degludec (IDeg) and liraglutide alone.
  
  
  
  We analyzed nine-point self-monitored blood glucose (SMBG) profiles from two randomized trials involving IDegLira in patients with type 2 diabetes (T2D), and continuous glucose monitoring (CGM) data from a subset of patients in one of these trials to assess glycemic fluctuation and day-to-day variability.
  
  
  
  Compared with IDeg, IDegLira resulted in a greater proportion of subjects with SMBG values within target ranges (3.9-9.0 mmol/L) than IDeg for all pre- and postprandial values, and for the full nine-point profile (P < 0.05 for all). IDegLira also resulted in a greater reduction in the range of SMBG values over 24 h than IDeg (P ≤ 0.0001). CGM data showed that IDegLira provided greater reductions in interstitial glucose (IG) fluctuation (P = 0.0018) and postprandial IG increment (P = 0.0288) compared with IDeg. Compared with liraglutide, IDegLira brought a higher proportion of subjects within SMBG target ranges (all pre- and all postprandial values, and the full nine-point profile, P < 0.01 for all) and resulted in a greater reduction of time outside the IG target range (P = 0.0072). IDegLira also reduced mean IG more than liraglutide (P < 0.0001).
  
  
  
  Treatment with IDegLira allows more patients with T2D to maintain blood glucose within target ranges throughout the day than either IDeg or liraglutide alone.
authors.affiliation: 1 Diabetes Care Center , Salinas, California.
authors.forename: Allen B
authors.initials: AB
authors.lastname: King
authors.affiliation: 2 Scripps Whittier Diabetes Institute , San Diego, California.
authors.forename: Athena
authors.initials: A
authors.lastname: Philis-Tsimikas
authors.affiliation: 3 Sidra Medical and Research Center , Doha, Qatar .
authors.forename: Eric S
authors.initials: ES
authors.lastname: Kilpatrick
authors.affiliation: 4 Novo Nordisk A/S , Søborg, Denmark .
authors.forename: Irene H
authors.initials: IH
authors.lastname: Langbakke
authors.affiliation: 4 Novo Nordisk A/S , Søborg, Denmark .
authors.forename: Kamilla
authors.initials: K
authors.lastname: Begtrup
authors.affiliation: 5 Center for Diabetes Research, Gentofte Hospital, University of Copenhagen , Copenhagen, Denmark.
authors.forename: Tina
authors.initials: T
authors.lastname: Vilsbøll
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D049528:Insulin, Long-Acting / Q000008:administration & dosage / Q000627:therapeutic use*; D000069450:Liraglutide / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D049528:Insulin, Long-Acting; C571886:insulin degludec; D000069450:Liraglutide
keywords: Continuous glucose monitoring; GLP-1 analog; Insulin degludec; Liraglutide; Type 2 diabetes