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14-09-2018 | Insulin glargine/Lixisenatide | Article

Bedtime-to-Morning Glucose Difference and iGlarLixi in Type 2 Diabetes: Post Hoc Analysis of LixiLan-L

Journal: Diabetes Therapy

Authors: Ariel Zisman, Terry Dex, Michelle Roberts, Aramesh Saremi, Jason Chao, Vanita R. Aroda

Publisher: Springer Healthcare

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Abstract

Introduction

A difference of ≥ 50–55 mg/dL between bedtime and morning glucose (BeAM) values in patients with type 2 diabetes (T2D) on basal insulin is an indicator of poor postprandial glucose control. This analysis compared the effect of treatment with a fixed-ratio combination of insulin glargine/lixisenatide (iGlarLixi) vs insulin glargine (iGlar) on BeAM values, and evaluated the impact of BeAM values on glycemic and safety endpoints.

Methods

In this post hoc analysis of 517 participants from the LixiLan-L trial, change in BeAM values and composite efficacy and safety endpoints stratified by BeAM value < 55 mg/dL or ≥ 55 mg/dL were evaluated in patients with T2D uncontrolled on basal insulin randomized to iGlarLixi or iGlar over 30 weeks (LixiLan-L).

Results

Greater reductions in BeAM values were seen with iGlarLixi vs iGlar, and a higher proportion of patients reached a BeAM value < 55 mg/dL in the iGlarLixi arm. A BeAM value < 55 mg/dL was associated with improved glycemic control, lower risk of hypoglycemia, and a greater proportion of patients achieving glycemic targets without hypoglycemia or weight gain. Greater reductions in BeAM values were seen with iGlarLixi vs iGlar, irrespective of stratification by glycated hemoglobin A1c or glycemic endpoints.

Conclusions

Greater reductions in bedtime-to-morning glucose differential, or BeAM, were observed with iGlarLixi vs iGlar in patients with T2D uncontrolled on basal insulin, reflecting better overall control of both fasting and prandial glucose and more appropriate matching of therapy to physiologic needs.

Trial Registration

ClinicalTrials.gov Identifier NCT02058160.

Funding

Sanofi US, Inc.
Literature
1.
Raccah D, Chou E, Colagiuri S, et al. A global study of the unmet need for glycemic control and predictor factors among patients with type 2 diabetes mellitus who have achieved optimal fasting plasma glucose control on basal insulin. Diabetes Metab Res Rev. 2017;33:e2858.CrossRef
2.
Khunti K, Millar-Jones D. Clinical inertia to insulin initiation and intensification in the UK: a focused literature review. Prim Care Diabetes. 2017;11:3–12.CrossRefPubMed
3.
Johnson EL, Frias JP, Trujillo JM. Anticipatory guidance in type 2 diabetes to improve disease management; next steps after basal insulin. Postgrad Med. 2018;130:365–74.CrossRefPubMed
4.
Blonde L, Meneghini L, Peng XV, et al. Probability of achieving glycemic control with basal insulin in patients with type 2 diabetes in real-world practice in the USA. Diabetes Ther. 2018;9:1347–58.CrossRefPubMedPubMedCentral
5.
American Diabetes Association. Standards of medical care in diabetes. Diabetes Care. 2018;41(Suppl. 1):S1–S159.
6.
Zisman A, Morales F, Stewart J, Stuhr A, Vlajnic A, Zhou R. BeAM value: an indicator of the need to initiate and intensify prandial therapy in patients with type 2 diabetes mellitus receiving basal insulin. BMJ Open Diabetes Res Care. 2016;4:e000171.CrossRefPubMedPubMedCentral
7.
Meier JJ, Rosenstock J, Hincelin-Méry A, et al. Contrasting effects of lixisenatide and liraglutide on postprandial glycemic control, gastric emptying, and safety parameters in patients with type 2 diabetes on optimized insulin glargine with or without metformin: a randomized, open-label trial. Diabetes Care. 2015;38:1263–73.CrossRefPubMed
8.
Davidson JA. Differential effects of prandial and non-prandial GLP-1 receptor agonists in type 2 diabetes therapy. Postgrad Med. 2015;127:827–41.CrossRefPubMed
9.
Aroda VR, Rosenstock J, Wysham C, et al. Efficacy and safety of LixiLan, a titratable fixed-ratio combination of insulin glargine plus lixisenatide in type 2 diabetes inadequately controlled on basal insulin and metformin: the LixiLan-L randomized trial. Diabetes Care. 2016;39:1972–80.CrossRefPubMed
10.
Leiter LA, Chao J, Dex T, Saremi A, Davidson J. A1c target attainment in patients with T2D receiving iGlarLixi who reach PPG and FPG targets in the LixiLan-L trial. Abstract presented at the American Diabetes Association 78th Annual Scientific Sessions, 22–26 June, 2018, Orlando, FL, USA. Diabetes. 2018;67(Suppl 1):A290.

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