Higher Derived Time in Range With IDegLira Versus Insulin Glargine U100 in People With Type 2 Diabetes.

Background: Derived time in range (dTIR), calculated from self-monitored blood glucose (SMBG-dTIR) profiles, has demonstrated correlation with risk of cardiovascular and microvascular complications. This post hoc analysis of the DUAL V and DUAL VIII trials aimed to compare dTIR with an insulin degludec/liraglutide fixed-ratio combination (IDegLira) versus insulin glargine 100 units/mL (glargine U100) in people with type 2 diabetes (T2D).
Materials and Methods: Nine-point SMBG profiles were taken more than 24 hours at baseline and end of trial (EOT: 26 weeks [DUAL V] and 104 weeks [DUAL VIII]) and used to derive the percentage of readings within target range (70-180 mg/dL). Estimated treatment differences (ETDs, IDegLira-glargine U100) were analyzed using analysis of covariance, with treatment as fixed effects and baseline response as a covariate.
Results: ETDs for change from baseline to EOT in dTIR were significantly greater with IDegLira versus glargine U100 in DUAL V (4.18%, P = .027) and DUAL VIII (5.17%, P = .001). The proportions of people achieving ≥70% dTIR at EOT with IDegLira and glargine U100, respectively, were 62% and 60% in DUAL V ( P = .7541), and 50% and 26% in DUAL VIII ( P < .0001). The proportion achieving a ≥5% increase in dTIR from baseline to EOT with IDegLira and glargine U100 was 63% in both groups in DUAL V ( P = .9043), and 44% and 25%, respectively, in DUAL VIII ( P < .0001).
Conclusions: IDegLira was associated with significantly greater increases in dTIR versus basal insulin alone in people with T2D.
Trial Id(s): ClinicalTrials.gov, NCT01952145 (DUAL V); ClinicalTrials.gov, NCT02501161 (DUAL VIII).
Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: AP-T provides consulting and research services to Novo Nordisk, Lilly, Bayer, Dexcom, and Medtronic on behalf of her employer but receives no direct or indirect reimbursement for the services. VRA reports consulting fees from Applied Therapeutics, Fractyl, Novo Nordisk, Pfizer, Sanofi, and institutional contracts for research from Applied Therapeutics/Medpace, Eli Lilly, Premier/Fractyl, Novo Nordisk, and Sanofi/Medpace. Her spouse is an employee of Janssen. CDB reports consulting fees and honoraria for speaking for Abbott, AstraZeneca, Boehringer-Ingelheim, Eli Lilly, Insulet, Medtronic, Novo Nordisk, and Roche. LKB reports honoraria for attending advisory boards or consulting services provided to Lilly, Novo Nordisk, Xeris, Bayer, and Sanofi. AL has received research support and honoraria for giving presentations and attending advisory boards: AstraZeneca, Bayer, Becton Dickinson, Boehringer-Ingelheim, Bristol Myers Squibb, Lilly, Medtronic, MSD, Novo Nordisk, Roche, and Sanofi. IL reports receiving advisory board fees and consulting fees from AstraZeneca, consulting fees from Bayer Healthcare Pharmaceuticals, Eli Lilly and Company, Intarcia, Intercept Pharmaceuticals, Janssen Global Services, MannKind Corporation, Target Pharma, Valeritas, and Zealand Pharma; advisory board fees from Boehringer-Ingelheim and Sanofi US Services; grant support, paid to UT Southwestern, from Merck; grant support, paid to her institution, from Mylan Pharmaceuticals and Pfizer; grant support, paid to UT Southwestern; and advisory board fees, consulting fees, and travel support from Novo Nordisk. RS and JMD’C are employees of Novo Nordisk A/S.