Oya Junko, Nakagami Tomoko, Hasegawa Yukiko, Kondo Yuichiro, Katamine Aki, Shimizu Mika, Kubota Ryo, Suda Rika, Babazono Tetsuya
Division of Diabetology and Metabolism, Department of Internal Medicine, Tokyo Women's Medical University School of Medicine, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666 Japan.
Diabetol Int. 2024 Jan 8;15(2):237-243. doi: 10.1007/s13340-023-00681-7. eCollection 2024 Apr.
To evaluate and compare the effectiveness of once-daily insulin degludec/liraglutide (IDegLira) to that of once-daily insulin degludec/insulin aspart (IDegAsp) after switching from basal insulin therapy at 6 months by assessing changes in hemoglobin A1c (HbA1c), body weight, and insulin doses in patients with type 2 diabetes (T2D).
A total of 91 patients with T2D with HbA1c levels exceeding 7.0% were included in this study. Adjusted least square mean changes in HbA1c, body weight, and total insulin doses were compared between the IDegLira group and IDegAsp group. Subgroup analyses were performed, stratified by median values of HbA1c (< 8.5 and ≥ 8.5%), obesity (body mass index < 25 and ≥ 25 kg/m), and basal insulin doses (< 14 and ≥ 14 units) at baseline to assess treatment interaction by subgroup.
The IDegLira group showed a greater reduction in HbA1c levels than the IDegAsp group (- 0.17 vs - 0.79%, = 0.003) with comparable body weight changes. The analyses of adjusted mean changes of total insulin doses showed that the IDegAsp group had a larger increase than the IDegLira group (3.64 vs 1.30 unis, = 0.016). The effect of IDegLira on HbA1c levels was superior to that of IDegAsp in patients with high HbA1c. There were no inter-group differences in the rate of hypoglycemic episodes.
Once-daily IDegLira had greater effects on HbA1c and a lesser increase in insulin doses than IDegAsp when patients are switched from basal insulin therapy. Moreover, the effect on HbA1c was enhanced in patients with high HbA1c levels at baseline.
通过评估2型糖尿病（T2D）患者糖化血红蛋白（HbA1c）、体重和胰岛素剂量的变化，比较一日一次的德谷胰岛素/利拉鲁肽（IDegLira）与一日一次的德谷胰岛素/门冬胰岛素（IDegAsp）在从基础胰岛素治疗转换6个月后的有效性。
本研究共纳入91例HbA1c水平超过7.0%的T2D患者。比较IDegLira组和IDegAsp组HbA1c、体重和总胰岛素剂量的调整后最小二乘均值变化。进行亚组分析，根据基线时HbA1c的中位数（<8.5%和≥8.5%）、肥胖（体重指数<25和≥25 kg/m²）和基础胰岛素剂量（<14和≥14单位）分层，以评估亚组间的治疗相互作用。
IDegLira组的HbA1c水平降低幅度大于IDegAsp组（-0.17%对-0.79%，P = 0.003），体重变化相当。总胰岛素剂量调整后均值变化分析显示，IDegAsp组的增加幅度大于IDegLira组（3.64单位对1.30单位，P = 0.016）。在HbA1c水平较高的患者中，IDegLira对HbA1c水平的影响优于IDegAsp。低血糖发作率在组间无差异。
当患者从基础胰岛素治疗转换时，一日一次的IDegLira对HbA1c的影响更大，胰岛素剂量增加幅度更小。此外，基线时HbA1c水平较高的患者对HbA1c的影响增强。
