Glycemic Control in a Real-Life Setting in Patients with Type 2 Diabetes Treated with IDegLira at a Single Swiss Center

Abstract

Introduction: The aim of the present study was to describe clinical outcomes in a real-world population of Swiss patients with long-standing, poorly controlled type 2 diabetes after switching to IDegLira [a combination of insulin degludec (IDeg) and liraglutide (Lira)]. Methods: This was a prospective, open-label, single-center observational follow-up at the Cabinet Medical de Diabétologie, Lausanne, Switzerland, of 61 patients [HbA1c 9.2% (77 mmol/mol) and 56.1 U total insulin] initiated with IDegLira at 20 dose steps (20 U IDeg/0.72 mg Lira), except in insulin-naïve patients who began treatment at 16 dose steps. Thereafter, the dose was titrated by four dose steps once weekly, according to individualized fasting blood glucose targets. Information about glycemic control, total insulin dose, weight, and blood pressure, along with any adverse events, was collected from medical records and patient reports during clinic visits at baseline, 3 months, and end of follow-up. Results: Over 6 months of follow-up, mean HbA1c improved (decrease of 1.7%) to 7.5% with concomitant weight loss. Switching to IDegLira resulted in a lower (−14.6 U) total insulin dose compared with baseline for those patients previously on insulin. There were no episodes of severe hypoglycemia during treatment with IDegLira. There were small decreases in both mean systolic and mean diastolic blood pressure with IDegLira. Six patients discontinued treatment early because of adverse gastrointestinal events with IDegLira. Conclusion: Switching to IDegLira, mostly from regimens using insulin in conjunction with oral antidiabetic medications in a real-world population of patients with type 2 diabetes, resulted in improved glucose control with a lower insulin dose and weight loss.