Switching from Insulin Degludec plus Dipeptidyl Peptidase-4 Inhibitor to Insulin Degludec/Liraglutide Improves Glycemic Variability in Patients with Type 2 Diabetes: A Preliminary Prospective Observation Study
Incretins reduce glycemic variability (GV) in patients with type 2 diabetes, but it is unknown whether switching from a combination of basal insulin and a DPP-4 inhibitor to insulin degludec/liraglutide (IDegLira) improves GV. We performed an exploratory prospective observational study to compare th...
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | Journal of Diabetes Research |
| Online Access: | http://dx.doi.org/10.1155/2022/5603864 |
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| author | Yuki Oe Hiroshi Nomoto Akinobu Nakamura Saki Kuwabara Yuka Takahashi Ayano Yasui Rimi Izumihara Aika Miya Hiraku Kameda Kyu Yong Cho Tatsuya Atsumi Hideaki Miyoshi |
| author_facet | Yuki Oe Hiroshi Nomoto Akinobu Nakamura Saki Kuwabara Yuka Takahashi Ayano Yasui Rimi Izumihara Aika Miya Hiraku Kameda Kyu Yong Cho Tatsuya Atsumi Hideaki Miyoshi |
| author_sort | Yuki Oe |
| collection | DOAJ |
| description | Incretins reduce glycemic variability (GV) in patients with type 2 diabetes, but it is unknown whether switching from a combination of basal insulin and a DPP-4 inhibitor to insulin degludec/liraglutide (IDegLira) improves GV. We performed an exploratory prospective observational study to compare the effect of IDegLira and the combination on GV. We recruited hospitalized patients with type 2 diabetes who had stable glycemic control with insulin degludec (≤16 units/day) and taking a DPP-4 inhibitor. GV was analyzed using continuous glucose monitoring (CGM) before and after switching the medication to IDegLira. The principal endpoint was the change in mean amplitude of glycemic excursions (MAGE). Other indices of GV and CGM parameters were analyzed as the secondary endpoints. Fifteen participants were enrolled and 12 completed the study. In these participants, the DPP-4 inhibitor and insulin degludec were discontinued, and the equivalent dose of IDegLira was commenced. Switching to IDegLira significantly improved MAGE from 74.9 (60.3, 97.7) mg/dL to 64.8 (52.0, 78.2) mg/dL (P<0.05), as well as other indices of GV and 24-hour mean blood glucose concentration. Analysis of the ambulatory glucose profile showed marked reductions in postprandial glucose concentration. Nocturnal glucose concentration was similar under the two treatment regimens. IDegLira improved GV as well as the mean and the postprandial glucose concentration by switching from insulin degludec plus DPP-4 inhibitor combination. IDegLira might be beneficial for patients being treated with low-dose basal insulin. |
| format | Article |
| id | doaj-art-95d254e3cb694b1fabb0ca8ce6bf496b |
| institution | DOAJ |
| issn | 2314-6753 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Diabetes Research |
| spelling | doaj-art-95d254e3cb694b1fabb0ca8ce6bf496b2025-08-20T03:20:33ZengWileyJournal of Diabetes Research2314-67532022-01-01202210.1155/2022/5603864Switching from Insulin Degludec plus Dipeptidyl Peptidase-4 Inhibitor to Insulin Degludec/Liraglutide Improves Glycemic Variability in Patients with Type 2 Diabetes: A Preliminary Prospective Observation StudyYuki Oe0Hiroshi Nomoto1Akinobu Nakamura2Saki Kuwabara3Yuka Takahashi4Ayano Yasui5Rimi Izumihara6Aika Miya7Hiraku Kameda8Kyu Yong Cho9Tatsuya Atsumi10Hideaki Miyoshi11Department of RheumatologyDepartment of RheumatologyDepartment of RheumatologyDepartment of RheumatologyDepartment of RheumatologyDepartment of RheumatologyDepartment of RheumatologyDepartment of RheumatologyDepartment of RheumatologyDepartment of RheumatologyDepartment of RheumatologyDepartment of RheumatologyIncretins reduce glycemic variability (GV) in patients with type 2 diabetes, but it is unknown whether switching from a combination of basal insulin and a DPP-4 inhibitor to insulin degludec/liraglutide (IDegLira) improves GV. We performed an exploratory prospective observational study to compare the effect of IDegLira and the combination on GV. We recruited hospitalized patients with type 2 diabetes who had stable glycemic control with insulin degludec (≤16 units/day) and taking a DPP-4 inhibitor. GV was analyzed using continuous glucose monitoring (CGM) before and after switching the medication to IDegLira. The principal endpoint was the change in mean amplitude of glycemic excursions (MAGE). Other indices of GV and CGM parameters were analyzed as the secondary endpoints. Fifteen participants were enrolled and 12 completed the study. In these participants, the DPP-4 inhibitor and insulin degludec were discontinued, and the equivalent dose of IDegLira was commenced. Switching to IDegLira significantly improved MAGE from 74.9 (60.3, 97.7) mg/dL to 64.8 (52.0, 78.2) mg/dL (P<0.05), as well as other indices of GV and 24-hour mean blood glucose concentration. Analysis of the ambulatory glucose profile showed marked reductions in postprandial glucose concentration. Nocturnal glucose concentration was similar under the two treatment regimens. IDegLira improved GV as well as the mean and the postprandial glucose concentration by switching from insulin degludec plus DPP-4 inhibitor combination. IDegLira might be beneficial for patients being treated with low-dose basal insulin.http://dx.doi.org/10.1155/2022/5603864 |
| spellingShingle | Yuki Oe Hiroshi Nomoto Akinobu Nakamura Saki Kuwabara Yuka Takahashi Ayano Yasui Rimi Izumihara Aika Miya Hiraku Kameda Kyu Yong Cho Tatsuya Atsumi Hideaki Miyoshi Switching from Insulin Degludec plus Dipeptidyl Peptidase-4 Inhibitor to Insulin Degludec/Liraglutide Improves Glycemic Variability in Patients with Type 2 Diabetes: A Preliminary Prospective Observation Study Journal of Diabetes Research |
| title | Switching from Insulin Degludec plus Dipeptidyl Peptidase-4 Inhibitor to Insulin Degludec/Liraglutide Improves Glycemic Variability in Patients with Type 2 Diabetes: A Preliminary Prospective Observation Study |
| title_full | Switching from Insulin Degludec plus Dipeptidyl Peptidase-4 Inhibitor to Insulin Degludec/Liraglutide Improves Glycemic Variability in Patients with Type 2 Diabetes: A Preliminary Prospective Observation Study |
| title_fullStr | Switching from Insulin Degludec plus Dipeptidyl Peptidase-4 Inhibitor to Insulin Degludec/Liraglutide Improves Glycemic Variability in Patients with Type 2 Diabetes: A Preliminary Prospective Observation Study |
| title_full_unstemmed | Switching from Insulin Degludec plus Dipeptidyl Peptidase-4 Inhibitor to Insulin Degludec/Liraglutide Improves Glycemic Variability in Patients with Type 2 Diabetes: A Preliminary Prospective Observation Study |
| title_short | Switching from Insulin Degludec plus Dipeptidyl Peptidase-4 Inhibitor to Insulin Degludec/Liraglutide Improves Glycemic Variability in Patients with Type 2 Diabetes: A Preliminary Prospective Observation Study |
| title_sort | switching from insulin degludec plus dipeptidyl peptidase 4 inhibitor to insulin degludec liraglutide improves glycemic variability in patients with type 2 diabetes a preliminary prospective observation study |
| url | http://dx.doi.org/10.1155/2022/5603864 |
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