Treatment of type 2 diabetes mellitus with GLP1 receptor agonists can result in long-term glycaemic control or can fail over time, in which case insulin can be used as an alternative or as an additive treatment. New research shows that the latter is more likely to achieve glycaemic targets than the former.
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References
Montvida, O., Kleine, K., Kumar, S., Khunti, K. & Paul, S. K. Addition or switch to insulin therapy in people treated with GLP-1 receptor agonists: a real world study in 66,583 patients. Diabetes Obes. Metab. http://dx.doi.org/10.1111/dom.12790, (2016).
Buse, J. B. et al. Use of twice-daily exenatide in basal insulin-treated patients with type 2 diabetes: a randomized, controlled trial. Ann. Intern. Med. 154, 103–112 (2011).
DeVries, J. H. et al. Sequential intensification of metformin treatment in type 2 diabetes with liraglutide followed by randomized addition of basal insulin prompted by A1C targets. Diabetes Care 35, 1446–1454 (2012).
Gough, S. C. et al. Efficacy and safety of a fixed-ratio combination of insulin degludec and liraglutide (IDegLira) compared with its components given alone: results of a phase 3, open-label, randomised, 26-week, treat-to-target trial in insulin-naive patients with type 2 diabetes. Lancet Diabetes Endocrinol. 2, 885–893 (2014).
Rosenstock, J. et al. Benefits of LixiLan, a titratable fixed-ratio combination of insulin glargine plus lixisenatide, versus insulin glargine and lixisenatide monocomponents in type 2 diabetes inadequately controlled with oral agents: the LixiLan-O randomized trial. Diabetes Care http://dx.doi.org/10.2337/dc16-0917, (2016).
Balena, R., Hensley, I. E., Miller, S. & Barnett, A. H. Combination therapy with GLP-1 receptor agonists and basal insulin: a systematic review of the literature. Diabetes. Obes. Metab. 15, 485–502 (2013).
Eng, C., Kramer, C. K., Zinman, B. & Retnakaran, R. Glucagon-like peptide-1 receptor agonist and basal insulin combination treatment for the management of type 2 diabetes: a systematic review and meta-analysis. Lancet 384, 2228–2234 (2014).
Abdul-Ghani, M. A., Williams, K., Kanat, M., Altuntas, Y. & DeFronzo, R. A. Insulin versus GLP-1 analogues in poorly controlled type 2 diabetic subjects on oral therapy: a meta-analysis. J. Endocrinol. Invest. 36, 168–173 (2013).
Buse, J. B. et al. Is insulin the most effective injectable antihyperglycaemic therapy? Diabetes Obes. Metab. 17, 145–151 (2015).
Tabak, A. G. et al. Trajectories of glycaemia, insulin sensitivity, and insulin secretion before diagnosis of type 2 diabetes: an analysis from the Whitehall II study. Lancet 373, 2215–2221 (2009).
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M.A.N. declares that he has received personal fees, grants, non-financial support or other support from AstraZeneca, Berlin Chemie-AG, Boehringer Ingelheim, Eli Lilly, GlaxoSmithKline, Hoffmann La Roche, Intarcia Therapeuticals, Janssen Global Services, Medscape LLC, Merck Sharp & Dohme, Novartis, Novo Nordisk, Sanofi-Aventis and Versartis. J.J.M. declares that he has received grants or personal fees from Astra Zeneca, Berlin-Chemie, Boehringer-Ingelheim, Eli Lilly, MSD, NovoNordisk, Sanofi and Servier.
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Nauck, M., Meier, J. Incretin mimetics and insulin — closing the gap to normoglycaemia. Nat Rev Endocrinol 12, 689–690 (2016). https://doi.org/10.1038/nrendo.2016.180
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DOI: https://doi.org/10.1038/nrendo.2016.180