Recent Evidence for Fixed-Ratio Combinations of Basal Insulin and GLP-1 RA vs. Basal-Bolus Insulin in T2D: Updates from ADA 2022

Fixed-ratio combinations of basal insulin and glucagon-like peptide-1 receptor agonist (GLP-1 RA) have demonstrated maintenance of HbA1c efficacy, less hypoglycemia, and weight loss compared to basal-bolus insulin therapies in previous trials, but what is the latest evidence comparing these strategies in those with type 2 diabetes?

Our host, Dr. Ronald Goldenberg, takes a deeper look into this topic with Dr. Jeremy Gilbert, an endocrinologist at the Sunnybrook Health Sciences Centre and Associate Professor at the University of Toronto Department of Medicine. He has authored chapters in recent Diabetes Canada Clinical Practice Guidelines and is the national lead for dissemination and implementation for the current guidelines. He is also an executive and national editor for the Canadian Journal of Diabetes, and the endocrinology section chair at the Royal College and Surgeons of Canada.

This episode discusses data from several studies recently presented at the ADA 2022 Scientific Sessions comparing fixed-ratio combinations of basal insulin and GLP-1 RA vs. basal-bolus regimens in type 2 diabetes, including the SoliSimplify and SoliComplex Real-World Studies, and the IDegLira HIGH Trial.

The SoliSimplify and SoliComplex Studies directly compared iGlarLixi (insulin glargine 100 U/mL and lixisenatide) vs. a basal-bolus regimen in those with type 2 diabetes advancing from basal insulin therapy, evaluating HbA1c and body weight outcomes, and treatment persistence and adherence outcomes, respectively. The IDegLira HIGH Trial compared the efficacy and safety of IDegLira (insulin degludec and liraglutide) vs. a basal-bolus regimen in those with poorly controlled type 2 diabetes and very high HbA1c. Our experts also dive into the relevance and applicability of these recent study findings to clinical practice.

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The views and opinions expressed in this episode are those of the speakers and do not necessarily reflect the views or positions of any entities they represent.

Declaration of conflict of interest:

Dr. Goldenberg:

• Direct financial relationship including receipt of honoraria: Abbott, Agora, Amgen, Antibody, AstraZeneca, Bayer, Boehringer Ingelheim, CCRN, CMSKTRG, Eli Lilly, EOCI, HIT Global, HLS, Inceptus, Janssen, LiV, Master Clinician Alliance, MD Briefcase, Merck, Mylan, Novo Nordisk, Sanofi, Script Medical, Servier, STA, Takeda, Toronto Knowledge Translation Working Group, Unik, Valeant. Membership on advisory boards or speaker’s bureau: Abbott, AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly, HLS, Janssen, Merck, Novo Nordisk, Sanofi. Funded grants, research or clinical trials: Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Janssen, Merck, Novo Nordisk, Sanofi. 

Dr. Gilbert:

• Membership on advisory boards or speaker’s bureau: Abbott, Astra Zeneca, Amgen, Bayer, Boerhringer, Dexcom, Eli Lilly, HLS therapeutics, Janssen, Phizer, Novo Nordisk, Sanofi.