Most type 2 diabetes patients treated with basal insulin don’t achieve adequate glucose control. But intensifying the insulin dose can increase the risk of hypoglycaemia and weight gain.
Researchers studied 557 patients with uncontrolled type 2 diabetes despite treatment with insulin glargine and metformin. They were randomly assigned to have their insulin dose titrated up or to receive treatment with insulin degludec and GLP-1 receptor agonist liraglutide in a single formulation.
Over 26 weeks, the degludec and liraglutide combination treatment significantly reduced glycated haemoglobin (HbA1c) levels compared with continued insulin titration. Patients also experienced fewer hypoglycaemic episodes and greater weight loss, the researchers report in JAMA (online, 1 March 2016)
The researchers conclude that combinations of insulin and GLP-1 receptor agonists could overcome barriers to glucose control in type 2 diabetes, but longer-term studies are needed.
 Lingvay I, Perez Manghi F, Garcia-Hernandez P, et al. Effect of Insulin Glargine Up-titration vs Insulin Degludec/Liraglutide on Glycated Hemoglobin Levels in Patients With Uncontrolled Type 2 Diabetes. JAMA 2016; 315: 898-907. doi: 10.1001/jama.2016.1252