medwireNews: Adding a weekly semaglutide injection in people already using basal insulin to treat type 2 diabetes avoids the need for prandial insulin, show the SUSTAIN 11 findings.
During 52 weeks of treatment, semaglutide was statistically noninferior to insulin aspart for the primary endpoint of change in glycated hemoglobin (HbA1c), report the investigators in Diabetes, Obesity and Metabolism.
HbA1c fell by an average of 1.5% (16.6 mmol/mol) among the 874 trial participants randomly assigned to take semaglutide 1.0 mg/week and by 1.2% (13.4 mmol/mol) among the 874 assigned to thrice-daily insulin aspart.
In addition, bodyweight decreased by an average of 4.1 kg in people taking semaglutide, but increased by 2.8 kg in those taking insulin aspart. There were very few instances of severe hypoglycemia in either treatment group, which Monika Kellerer (Marienhospital, Stuttgart, Germany) and co-researchers attribute to the “comparatively conservative insulin titration algorithms.”
The trial participants were aged an average of 61.2 years, with average HbA1c of 8.6% (70 mmol/mol), diabetes duration of 13.4 years, and BMI of 31.5 kg/m2. They all transferred to once-daily insulin glargine at the start of the trial, continued metformin, and discontinued any other medications.
“Despite the challenging population, results support the established, favorable benefit–risk profile of [once-weekly] semaglutide, which is in keeping with current guideline recommendations,” concludes the team.
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Diabetes Obes Metab 2022; doi:10.1111/dom.14765