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Achieving postprandial glucose control with lixisenatide improves glycemic control in patients with type 2 diabetes on basal insulin: a post-hoc analysis of pooled data.

Abstract

Background

To examine the impact on glycemic control of achieving postprandial glucose (PPG) target with lixisenatide, a once-daily glucagon-like peptide-1 receptor agonist approved in the US, in patients with uncontrolled type 2 diabetes (T2D) on basal insulin, an agent that primarily targets fasting plasma glucose.

Methods

A post hoc pooled analysis was conducted using clinical trial data extracted from the intent-to-treat subpopulation of patients with T2D who participated in the 24-week, phase 3, randomized, double-blind, placebo-controlled, 2-arm parallel-group, multicenter GetGoal-L (NCT00715624), GetGoal-Duo 1 (NCT00975286) and GetGoal-L Asia trials (NCT00866658).

Results

Data from 587 lixisenatide-treated patients and 484 placebo-treated patients were included. Patients on lixisenatide were more likely to achieve a PPG target of < 10 mmol/L (< 180 mg/dL) than placebo-treated patients (P < 0.001), regardless of baseline fasting plasma glucose (FPG) levels. More importantly, those who reached the PPG target experienced a significantly greater reduction in mean HbA1c, were more likely to achieve HbA1c target of < 53 mmol/mol (< 7.0%), and experienced weight loss. Those outcomes were achieved with no significant differences in the risk of symptomatic hypoglycemia compared with placebo.

Conclusion

Compared with placebo, addition of lixisenatide to basal insulin improved HbA1c and reduced PPG, without increasing hypoglycemia risk. These findings highlight the importance of PPG control in the management of T2D, and provide evidence that adding an agent to basal insulin therapy that also impacts PPG has therapeutic value for patients who are not meeting glycemic targets.

Trial registration

NCT00715624. Registered 15 July 2008, NCT00975286. Registered 11 September 2009, NCT00866658. Registered 20 March 2009.

Authors+Show Affiliations

1Department of Internal Medicine, Touchstone Diabetes Center, The University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, K5.246, Dallas, TX 75390-8549 USA.2Sanofi US, Inc, Bridgewater, NJ USA.2Sanofi US, Inc, Bridgewater, NJ USA.2Sanofi US, Inc, Bridgewater, NJ USA.3Li Ka Shing Knowledge Institute, St Michael's Hospital, University of Toronto, Toronto, ON Canada.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31956422

Citation

Davidson, Jaime A., et al. "Achieving Postprandial Glucose Control With Lixisenatide Improves Glycemic Control in Patients With Type 2 Diabetes On Basal Insulin: a Post-hoc Analysis of Pooled Data." Clinical Diabetes and Endocrinology, vol. 6, 2020, p. 2.
Davidson JA, Stager W, Paranjape S, et al. Achieving postprandial glucose control with lixisenatide improves glycemic control in patients with type 2 diabetes on basal insulin: a post-hoc analysis of pooled data. Clin Diabetes Endocrinol. 2020;6:2.
Davidson, J. A., Stager, W., Paranjape, S., Berria, R., & Leiter, L. A. (2020). Achieving postprandial glucose control with lixisenatide improves glycemic control in patients with type 2 diabetes on basal insulin: a post-hoc analysis of pooled data. Clinical Diabetes and Endocrinology, 6, 2. https://doi.org/10.1186/s40842-019-0088-5
Davidson JA, et al. Achieving Postprandial Glucose Control With Lixisenatide Improves Glycemic Control in Patients With Type 2 Diabetes On Basal Insulin: a Post-hoc Analysis of Pooled Data. Clin Diabetes Endocrinol. 2020;6:2. PubMed PMID: 31956422.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Achieving postprandial glucose control with lixisenatide improves glycemic control in patients with type 2 diabetes on basal insulin: a post-hoc analysis of pooled data. AU - Davidson,Jaime A, AU - Stager,William, AU - Paranjape,Sachin, AU - Berria,Rachele, AU - Leiter,Lawrence A, Y1 - 2020/01/14/ PY - 2018/12/07/received PY - 2019/08/12/accepted PY - 2020/1/21/entrez PY - 2020/1/21/pubmed PY - 2020/1/21/medline KW - Glucagon-like peptide-1 receptor KW - Glycemic targets KW - Lixisenatide KW - Post-prandial glucose KW - Type 2 diabetes SP - 2 EP - 2 JF - Clinical diabetes and endocrinology JO - Clin Diabetes Endocrinol VL - 6 N2 - Background: To examine the impact on glycemic control of achieving postprandial glucose (PPG) target with lixisenatide, a once-daily glucagon-like peptide-1 receptor agonist approved in the US, in patients with uncontrolled type 2 diabetes (T2D) on basal insulin, an agent that primarily targets fasting plasma glucose. Methods: A post hoc pooled analysis was conducted using clinical trial data extracted from the intent-to-treat subpopulation of patients with T2D who participated in the 24-week, phase 3, randomized, double-blind, placebo-controlled, 2-arm parallel-group, multicenter GetGoal-L (NCT00715624), GetGoal-Duo 1 (NCT00975286) and GetGoal-L Asia trials (NCT00866658). Results: Data from 587 lixisenatide-treated patients and 484 placebo-treated patients were included. Patients on lixisenatide were more likely to achieve a PPG target of < 10 mmol/L (< 180 mg/dL) than placebo-treated patients (P < 0.001), regardless of baseline fasting plasma glucose (FPG) levels. More importantly, those who reached the PPG target experienced a significantly greater reduction in mean HbA1c, were more likely to achieve HbA1c target of < 53 mmol/mol (< 7.0%), and experienced weight loss. Those outcomes were achieved with no significant differences in the risk of symptomatic hypoglycemia compared with placebo. Conclusion: Compared with placebo, addition of lixisenatide to basal insulin improved HbA1c and reduced PPG, without increasing hypoglycemia risk. These findings highlight the importance of PPG control in the management of T2D, and provide evidence that adding an agent to basal insulin therapy that also impacts PPG has therapeutic value for patients who are not meeting glycemic targets. Trial registration: NCT00715624. Registered 15 July 2008, NCT00975286. Registered 11 September 2009, NCT00866658. Registered 20 March 2009. SN - 2055-8260 UR - https://www.unboundmedicine.com/medline/citation/31956422/Achieving_postprandial_glucose_control_with_lixisenatide_improves_glycemic_control_in_patients_with_type_2_diabetes_on_basal_insulin:_a_post-hoc_analysis_of_pooled_data L2 - https://clindiabetesendo.biomedcentral.com/articles/10.1186/s40842-019-0088-5 DB - PRIME DP - Unbound Medicine ER -
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