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Basal insulin and glucagon-like peptide (GLP)-1 receptor agonists are individually effective for controlling blood glucose in patients with diabetes but are also associated with unwanted side effects.
A new fixed-ratio combination of insulin degludec, a basal insulin analogue, plus liraglutide, a GLP-1 analogue (IDegLira), has demonstrated better control of blood glucose than either drug given alone, and with no increase in hypoglycaemia.
Findings from the DUAL trial, reported in The Lancet Diabetes & Endocrinology (online, 2 September 2014), show that patients who took IDegLira (Xultophy) for 26 weeks experienced a significantly greater mean reduction in HbA1c (–1.9%) than patients taking either insulin degludec (–1.4%) or liraglutide (–1.3%)
Rates of hypoglycaemia were lowest with liraglutide, highest with insulin degludec and intermediate with IDegLira.
IDegLira, a single, once-daily injectable, is expected to be authorised for use in Europe within months.
 Gough SCL, Bode B, Woo V 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. The Lancet Diabetes & Endocrinology 2014. doi:10.1016/S2213-8587(14)70174-3 (accessed 15 September 2014)