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 targ...
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doaj-2e5a5fd82d6f44e590d28a4c4d912c0e2021-01-17T12:57:51ZengBMCClinical Diabetes and Endocrinology2055-82602020-01-01611710.1186/s40842-019-0088-5Achieving postprandial glucose control with lixisenatide improves glycemic control in patients with type 2 diabetes on basal insulin: a post-hoc analysis of pooled dataJaime A. Davidson0William Stager1Sachin Paranjape2Rachele Berria3Lawrence A. Leiter4Department of Internal Medicine, Touchstone Diabetes Center, The University of Texas Southwestern Medical CenterSanofi US, IncSanofi US, IncSanofi US, IncLi Ka Shing Knowledge Institute, St Michael’s Hospital, University of TorontoAbstract 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.https://doi.org/10.1186/s40842-019-0088-5Type 2 diabetesLixisenatideGlucagon-like peptide-1 receptorPost-prandial glucoseGlycemic targets |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jaime A. Davidson William Stager Sachin Paranjape Rachele Berria Lawrence A. Leiter |
spellingShingle |
Jaime A. Davidson William Stager Sachin Paranjape Rachele Berria Lawrence A. Leiter 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 Type 2 diabetes Lixisenatide Glucagon-like peptide-1 receptor Post-prandial glucose Glycemic targets |
author_facet |
Jaime A. Davidson William Stager Sachin Paranjape Rachele Berria Lawrence A. Leiter |
author_sort |
Jaime A. Davidson |
title |
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 |
title_short |
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 |
title_full |
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 |
title_fullStr |
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 |
title_full_unstemmed |
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 |
title_sort |
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 |
publisher |
BMC |
series |
Clinical Diabetes and Endocrinology |
issn |
2055-8260 |
publishDate |
2020-01-01 |
description |
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. |
topic |
Type 2 diabetes Lixisenatide Glucagon-like peptide-1 receptor Post-prandial glucose Glycemic targets |
url |
https://doi.org/10.1186/s40842-019-0088-5 |
work_keys_str_mv |
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