iGlarlixi for the simplification of more complex insulin regimens in type 2 diabetes patients with good glycaemic control.

AIMS: Knowledge on insulin treatment simplification with fixed ratio combinations (e.g. iGlarLixi, combination of insulin glargine and lixisenatide) is limited. Our aim was to examine long-term effectiveness and safety of treatment simplification with iGlarLixi in type 2 diabetes. MATERIALS AND METHODS: We report a single-centre, observational study of n=51 type 2 diabetes patients with HbA1c ≤ 7.5% (58 mmol/mol) who switched from basal-bolus or premixed insulins to iGlarLixi in 01/JAN/2017-30/JUN/2023 with up to 61-month follow-up. Outcomes were trajectories of HbA1c, BMI, insulin need, and risk of incident hypoglycaemia based on mixed linear models. RESULTS: Participants (53% women) were 69.4 years old, BMI was 30.6 kg/m2, diabetes duration 13 years, HbA1c 6.4% [46 mmol/mol]), and insulin dose 0.46 IU/kg at baseline. HbA1c remained stable over follow-up. BMI dropped to 29.4 kg/m2 (slope: 0.54, 95%CI: 0.34-0.73 kg/month) in the first 7 months, then remained stable. Insulin dose dropped by 0.20 IU/kg (95%CI: 0.17-0.24) at baseline, then remained stable. Risk of hypoglycaemia decreased from 50 to 21% (odds ratio [OR] 0.88, 95%CI: 0.82-0.95/months) during the first 10 months, then remained stable. Subgroup analyses showed increasing HbA1c within the non-diabetic range in patients with very low and improvement in those with higher values. Furthermore, the subgroup with large BMI and low insulin dose at baseline had stable BMI trajectory (vs a decrease in all other subgroups). CONCLUSIONS: Simplification of complex regimens with iGlarLixi in patients with good glycaemic control maintains glycaemic control with weight loss, reduced risk of hypoglycaemia, and lower insulin dose over 42 months.