IDegLira combination drug improves HbA1c more than insulin glargine in people with type 2 diabetes

A new combination drug is more beneficial for people with type 2 diabetes than insulin glargine plus metformin, according to new research.
The study, which was conducted by researchers at the University of North Carolina School of Medicine, found that IDegLira, a drug that combines the basal insulin degludec (trade name Tresiba) with liraglutide (trade name Victoza), a GLP-1 receptor agonist. IDegLira is administered through daily injection.
“It’s quite remarkable that IDegLira can achieve such excellent control of diabetes in the toughest group of patients we treat,” said John Buse, MD, PhD, Professor of Medicine at the UNC School of Medicine and director of the UNC Diabetes Care Centre.
How was the study conducted?
The researchers analysed data from 557 patients, all of whom had uncontrolled type 2 diabetes after taking insulin glargine and metformin. The participants were divided into two groups: the first was given more glargine, whereas the second was given IDegLira shots. All participants continued to take metformin.
Both groups lowered their fasting glucose levels, but the drop was much more pronounced in the IDegLira group. The IDegLira group saw a significant drop in HbA1c, from an average of 68.3mmol/mol (8.4 per cent) to 48.6 (6.6 per cent). In the glargine group, HbA1c levels dropped from 66.1 (8.2) to 54.1 (7.1).
The degludec/liraglutide combination also led to more significant weight loss than glargine alone, as well as being associated with fewer incidences of hypoglycemia.
“That 7.1 per cent still was very good for this patient group,” said Buse. “But the patients on IDegLira did better overall, especially when factoring in weight loss and significantly decreased hypoglycemia risk.
IDegLira: benefits and side effects
Side effects of IDegLira included nausea and other mild gastrointestinal side effects.
The benefits of IDegLira were explained by Ildiko Lingvay, associate professor of internal medicine and clinical sciences at University of Texas Southwestern Medical Centre, and first author of the study:
“The advantage of the combination product is that the treatment burden is the same as taking basal insulin – one shot a day – but you are getting an additional product that works through a different mechanism and addressed different pathophysiologic defects of the disease. The liraglutide affects satiety and induces weight loss, while also stimulating insulin secretion. The combination product addresses more underlying abnormalities present in this disease.”
The findings are published in JAMA: The Journal of the American Medical Association.