Takeaway
- Free or fixed combination treatment with glucagon-like peptide-1 receptor agonists (GLP-1RA) and basal insulin was associated with better glycaemic control vs insulin intensification strategy in patients with type 2 diabetes mellitus.
Why this matters
- Combination treatment improves outcomes in type 2 diabetes mellitus by multiple modes of action and without the risk of increasing hypoglycaemia with insulin intensification.
Study design
- Meta-analysis of 11 randomised controlled trials comparing free or fixed combination of a GLP-1RA plus basal insulin vs insulin intensification in 6176 patients with type 2 diabetes.
- Funding: None.
Key results
- Combination treatment vs insulin up-titration was associated with:
- lower mean HbA1c (weighted mean difference [WMD], −0.53%, P<.001);
- higher proportion of patients achieving HbA1c target (relative risk [RR], 1.69; P<.001);
- similar hypoglycaemic events (RR, 0.97, P=.114); and
- greater weight reduction (WMD −1.9; P<.001).
- No difference was observed between free and fixed-dose combination treatment.
Limitations
- Heterogeneity between studies.
- Long-term data was not available.
References
References
