68567
document
Comparison of insulin glargine and liraglutide added to oral agents in patients with poorly controlled type 2 diabetes . AIM To compare safety and efficacy of insulin glargine and liraglutide in patients with type 2 diabetes ( T2DM ) . METHODS This randomized , multinational , open-label trial included subjects treated for T2DM with metformin ± sulphonylurea , who had glycated haemoglobin ( HbA1c ) levels of 7.5-12 % . Subjects were assigned to 24 weeks of insulin glargine , titrated to target fasting plasma glucose of 4.0-5.5 mmol/L or liraglutide , escalated to the highest approved clinical dose of 1.8 mg daily . The trial was powered to detect superiority of glargine over liraglutide in percentage of people reaching HbA1c < 7 % . RESULTS The mean [ standard deviation ( s.d . ) ] age of the participants was 57 ( 9 ) years , the duration of diabetes was 9 ( 6 ) years , body mass index was 31.9 ( 4.2 ) kg/m ( 2 ) and HbA1c level was 9.0 ( 1.1 ) % . Equal numbers ( n = 489 ) were allocated to glargine and liraglutide . Similar numbers of subjects in both groups attained an HbA1c level of < 7 % ( 48.4 vs. 45.9 % ) ; therefore , superiority of glargine over liraglutide was not observed ( p = 0.44 ) . Subjects treated with glargine had greater reductions of HbA1c [ -1.94 % ( 0.05 ) and -1.79 % ( 0.05 ) ; p = 0.019 ] and fasting plasma glucose [ 6.2 ( 1.6 ) and 7.9 ( 2.2 ) mmol/L ; p < 0.001 ] than those receiving liraglutide . The liraglutide group reported a greater number of gastrointestinal treatment-emergent adverse events ( p < 0.001 ) . The mean ( s.d . ) weight change was +2.0 ( 4.0 ) kg for glargine and -3.0 ( 3.6 ) kg for liraglutide ( p < 0.001 ) . Symptomatic hypoglycaemia was more common with glargine ( p < 0.001 ) . A greater number of subjects in the liraglutide arm withdrew as a result of adverse events ( p < 0.001 ) . CONCLUSION Adding either insulin glargine or liraglutide to subjects with poorly controlled T2DM reduces HbA1c substantially , with nearly half of subjects reaching target levels of 7 % .
68568
Intervention_Pharmacological
insulin glargine
68569
Intervention_Pharmacological
liraglutide
68570
Intervention_Pharmacological
insulin glargine
68571
Intervention_Pharmacological
liraglutide
68572
Intervention_Pharmacological
insulin glargine
68573
Intervention_Pharmacological
liraglutide
68574
Intervention_Pharmacological
glargine
68575
Intervention_Pharmacological
liraglutide