Department of Endocrinology, Osmania Medical College, Hyderabad, India.
Rashid Hospital, Dubai, United Arab Emirates.
Diabetes Res Clin Pract. 2020 May;163:108148. doi: 10.1016/j.diabres.2020.108148. Epub 2020 Apr 14.
Hypoglycemia is one of the most important complications associated with Ramadan fasting in people with type 2 diabetes. LixiRam (NCT02941367) was the first randomized trial comparing safety and efficacy of lixisenatide + basal insulin (BI) vs. sulphonylurea + BI in people with type 2 diabetes who fast during Ramadan. This post hoc analysis focuses on the LixiRam study population from India.
Adults with type 2 diabetes insufficiently controlled with sulphonylurea + BI ± another oral anti-hyperglycemic drug were randomized 1:1 to receive lixisenatide + BI or to continue sulphonylurea + BI treatment.
In total, 150 participants were randomized in India. One participant (1.3%) with lixisenatide + BI vs. 5 participants (6.8%) with sulphonylurea + BI experienced ≥1 documented symptomatic hypoglycemic event during the Ramadan fast (odds ratio [OR]: 0.22; 95% confidence interval [CI]: 0.02-1.93). Incidence of any hypoglycemia was numerically lower with lixisenatide + BI vs. sulphonylurea + BI during Ramadan fasting (1.3% [1/75] vs. 14.7% [11/75], respectively; OR: 0.09; 95% CI: 0.01-0.69). No new safety signals were identified.
A combination of lixisenatide prandial GLP1-RA + BI may be a suitable treatment option for people with type 2 diabetes who elect to fast during Ramadan. Clinical Trial Registry: clinicaltrials.gov (NCT02941367).
低血糖是 2 型糖尿病患者在斋月禁食期间最常见的并发症之一。LixiRam(NCT02941367)是第一项比较利西那肽+基础胰岛素(BI)与磺酰脲类+BI 在斋月期间禁食的 2 型糖尿病患者的安全性和疗效的随机试验。本事后分析重点关注来自印度的 LixiRam 研究人群。
使用磺酰脲类+BI±另一种口服降糖药血糖控制不佳的 2 型糖尿病成人患者按 1:1 随机分组,分别接受利西那肽+BI 或继续磺酰脲类+BI 治疗。
在印度,共有 150 名参与者被随机分组。利西那肽+BI 组有 1 名(1.3%)参与者发生≥1 次有记录的症状性低血糖事件,磺酰脲类+BI 组有 5 名(6.8%)参与者发生(比值比[OR]:0.22;95%置信区间[CI]:0.02-1.93)。在斋月禁食期间,利西那肽+BI 组的任何低血糖发生率均低于磺酰脲类+BI 组(分别为 1.3%[1/75]和 14.7%[11/75];OR:0.09;95%CI:0.01-0.69)。未发现新的安全性信号。
利西那肽餐时 GLP1-RA+BI 联合治疗可能是选择在斋月禁食的 2 型糖尿病患者的合适治疗选择。临床试验注册:clinicaltrials.gov(NCT02941367)。