Combination therapy with GLP-1 RA and insulin: clinical phenotypes and metabolic effects

Objective of the study: To verify the improvement in glico-metabolic compensation and weight trend in patients assigned to the insulin degludec and liraglutide (IDegLira) combination therapy, after three months of therapy. Materials and methods: We included 61 adult patients referring to the Diabetology Unit of S. Salvatore Hospital in L’Aquila, during the period April-October 2023, who were assigned to IDegLira combination therapy because of unsatisfactory glycaemic compensation. A series of clinical and biochemical parameters were assessed at both baseline and follow-up at three months. All patients were divided into three categories according to their current diabetes therapy before the prescription of the new drug: “insulin naive”, “basal-oral failure”, “basal-bolus switch”. Results: After three months of IDegLira therapy there were statistically significant reductions in glycated haemoglobin (p-value <0.000), fasting blood glucose (p-value=0.003), body weight (p-value=0.003), and total cholesterol (p-value=0.041). There were no statistically significant differences in terms of glycated haemoglobin reduction according to sex: the mean delta of reduction of HbA1c was similar between males (1.76±1.53) and females (1.98±2.77). No patients showed serious side effects with the initiation of the IDegLira combination, and no patients experienced episodes of severe hypoglycemia. The most common mild side effects were related to early feelings of satiety and reduction of appetite, but these effects were fading with the passage of the weeks. Conclusion: The use of IDegLira demonstrated greater ease in the achievement of glaycemic goals, and increased patient compliance in using the device, thus minimizing the need for additional therapy. Here it has been proven to be an optimal therapy for diabetes control, with few side effects and better effects on metabolic and anthropometric parameters, thus making it a therapy to be considered early in a wide variety of diabetic patients.