Friday, September 22, 2023
Advances in
Second generation basal insulins have demonstrated clinical advantages over first-generation insulins, including less nocturnal hypoglycemia and greater dosing flexibility. Fixed-ratio combinations of basal insulin and GLP-1 RA provide effective glycemic control with a reduced hypoglycemia risk, mitigation of weight gain, and improved tolerability in T2DM. For T1DM, adjunctive non-insulin glucose-lowering agents may enable patients to achieve glycemic control with lower insulin doses, less hypoglycemia, glucose variability and weight gain. Education is needed to identify patients benefitting most from these novel therapies.
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Associate Professor, Department of Medicine, Universitat Autonoma de Barcelona; Director, Saint Martí Primary Health Centres (Catalonian National Health Service); Chairman, Primary Care Diabetes Europe, Barcelona, Spain
Professor of Diabetes Medicine, Diabetes Research Unit, University of Leicester; Honorary Consultant Physician, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
Chief Executive Officer, Principal Investigator, National Research Institute, Los Angeles, California, United States
Professor, Department of Family Medicine, Schulich School of Medicine & Dentistry, University of Western Ontario, Ontario, Canada
Head of Department, Professor of Primary Care Diabetes and Vascular Medicine, Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, United Kingdom
Professor of Internal Medicine; Head, Division of Endocrinology and Diabetes, Städtisches Klinikum, Munich, Germany
Verne S. Caviness Distinguished Professor; Chief, Division of Endocrinology; Director, North Carolina Translational and Clinical Sciences Institute; Executive Associate Dean, Clinical Research; University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
Professor, Hannover Medical School, Director, Children's Hospital AUF DER BULT, Hannover, Germany
Professor
University of Dundee
Dundee, United Kingdom
Educational slides on the role of novel basal insulins in therapy for T2DM
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Educational slides on the benefits of basal insulin/GLP-1 RA fixed ratio combinations
DownloadFreemantle N, Chou E, Frois C, et al. Safety and efficacy of insulin glargine 300 u/mL compared with other basal insulin therapies in patients with type 2 diabetes mellitus: a network meta-analysis. BMJ Open. 2016;6:e009421.
Aroda V, 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;39:1972-1980.
Rosenstock J, Aronson R, Grunberger G, et al. Benefits of LixiLan, a titratable fixed-ratio combination of insulin glargine plus lixisenatide, versus insulin glargine and lixisenatide monocomponents in type 2 diabetes inadequately controlled with oral agents: the LixiLan-O randomized trial. Diabetes Care. 2016;39:2026-2035.
Anderson SL, Trujillo JM. Basal insulin use with GLP-1 receptor agonists. Diabetes Spectr. 2016; 29:152–160.
Dalal MR, Kazemi M, Ye F, et al. Hypoglycemia after initiation of basal insulin in patients with type 2 diabetes in the United States: implications for treatment discontinuation and healthcare costs and utilization. Adv Ther. 2017;34:2083-2092.
Zhou FL, Ye F, Gupta V, et al. Lower risk of hypoglycemia after switch to insulin glargine 300 U/Ml (Gla-300) vs other basal insulins in patients with type 2 diabetes (T2D) on basal insulin in real-world clinical settings (DELIVER 2 study). 2017 Endocrine Society Annual Meeting. Poster presentation LB SUN 81.
Zhou FL, Ye F, Gupta V, et al. Older adults with type 2 diabetes (T2D) experience less hypoglycemia when switching to insulin glargine 300 u/mL (Gla-300) versus other basal insulins (DELIVER 3 study). ADA 77th Scientific Sessions, 2017. Abstract 986-P.
Schultes B, Tentolouris N, Knudesen ST, et al. Switching to insulin degludec improves glycemic control in patients with T2D in a real-world setting. ADA 77th Scientific Sessions, 2017. Abstract 1010-P.
Rosenstock J, Ampudia-Blasco F, Giorgino F, et al. Simultaneous vs sequential combination of insulin glargine and lixisenatide in type 2 diabetes uncontrolled on metformin. Abstract presented at the 53rd Annual Meeting of EASD; September 11-15, 2017; Lisbon, Portugal. Abstract 795.
Frias JP, Domingo MP, Meneghini L, et al. Shorter time to glycemic control with fixed-ratio combination of insulin glargine and lixisenatide compared with insulin glargine treatment alone. Abstract presented at the 53rd Annual Meeting of EASD; September 11-15, 2017; Lisbon, Portugal. Abstract 803.
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Steering Committee Member
Has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Novo Nordisk, Roche, Sanofi
Served as a speaker or a member of a speakers bureau for: AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals, Inc., Lilly, Menarini Group, Roche
Steering Committee Member
Has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: AstraZeneca Pharmaceuticals LP; Boehringer Ingelheim Pharmaceuticals, Inc.; Janssen Pharmaceuticals; Lilly; Merck Sharp & Dohme Corp.; Novo Nordisk; Sanofi-Aventis; SERVIER
Served as a speaker or a member of a speakers bureau for: AstraZeneca Pharmaceuticals LP; Boehringer Ingelheim Pharmaceuticals, Inc.; Janssen Pharmaceuticals; Lilly; Merck Sharp & Dohme Corp.; Mitsubishi Tanabe Pharma Corporation; Novo Nordisk; Sanofi-Aventis
Received grants for clinical research from: Boehringer Ingelheim Pharmaceuticals, Inc.; Janssen Pharmaceuticals; Lilly; Novo Nordisk; Sanofi-Aventis
Steering Committee Member
Has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Bristol-Myers Squibb Company, Johnson & Johnson Pharmaceutical Research & Development, L.L.C., Novo Nordisk, Sanofi
Served as a speaker or a member of a speakers bureau for: Novo Nordisk, Sanofi
Received grants for clinical research from: AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals, Inc., Bristol-Myers Squibb Company, Eli Lilly, Novo Nordisk, Pfizer Inc., Sanofi
Steering Committee Member
Has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals, Inc., Intarcia Therapeutics, Inc., Janssen Pharmaceuticals, Lilly, Sanofi
Served as a speaker or a member of a speakers bureau for: AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals, Inc., Intarcia Therapeutics, Inc., Janssen Pharmaceuticals, Lilly, Sanofi
Received grants for clinical research from: AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals, Inc., Intarcia Therapeutics, Inc., Janssen Pharmaceuticals, Lilly, Sanofi
Steering Committee Member
Has disclosed the following relevant financial relationships:
Served as an advisoror consultant for: AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals, Inc., Bristol-Myers Squibb Company, Janssen Pharmaceuticals, Lilly, Merck Sharp & Dohme Corp., Novartis Pharmaceuticals Corporation, Novo Nordisk, Roche, Sanofi
Served as a speaker or a member of a speakers bureau for: AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim Pharmaceuticals, Inc., Janssen Pharmaceuticals, Lilly, Merck Sharp & Dohme Corp., Novartis Pharmaceuticals Corporation, Novo Nordisk, Sanofi
Steering Committee Member
Has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Novo Nordisk; Sanofi; SERVIER
Served as a speaker or a member of a speakers bureau for: AstraZeneca Pharmaceuticals LP; Boehringer Ingelheim Pharmaceuticals, Inc.; Lilly; Merck Sharp & Dohme Corp.; Novartis Pharmaceuticals Corporation; Novo Nordisk; Sanofi
Steering Committee Member
Has disclosed the following relevant financial relationships:
Received grants for clinical research from: AstraZeneca, Boehringer Ingelheim, Johnson & Johnson, Lexicon, Novo Nordisk, Sanofi, Theracos, vTv Therapeutics
Owns stock, stock options, or bonds from: Mellitus Health, PhaseBio Pharmaceuticals
Other: Advisor under contracts with employer: Adocia, AstraZeneca, Dexcom, Elcelyx Therapeutics, Eli Lilly, IntarciaTherapeutics, Lexicon Metavention, NovaTarg, Novo Nordisk, Sanofi, Senseonics, and vTv Therapeutics
Steering Committee Member
Has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: AstraZeneca Pharmaceuticals LP; Boehringer Ingelheim Pharmaceuticals, Inc.; Medtronic, Inc.; Novo Nordisk; Sanofi
Served as an advisor or consultant for: AstraZeneca, Bayer HealthCare, Boehringer Ingelheim Pharmaceuticals, Inc., Bristol-Myers Squibb, Dexcom, Eli Lilly, GlaxoSmithKline, Johnson&Johnson, Medtronic, Novo Nordisk, Roche, Sanofi, Unomedical, Ypsomed
Served as a speaker or a member of a speakers bureau for: AstraZeneca, Eli Lilly, Novo Nordisk, Sanofi
Steering Committee Member
Has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Novo Nordisk, Sanofi
Served as a speaker or a member of a speakers bureau for: Novo Nordisk, Sanofi
New Horizons in Type 1 Diabetes Management
Supported by an independent educational grant from