Abstract
OBJECTIVE
To compare the efficacy of insulin degludec/liraglutide (IDegLira) versus insulin glargine, both combined with insulin aspart, for short-term intensive glycemic control in overweight or obese patients with type 2 diabetes mellitus (T2DM).
METHODS
In this randomized study, severely hyperglycemic overweight or obese patients with T2DM received 7-day intensive therapy with either IDegLira plus insulin aspart or insulin glargine plus insulin aspart. The primary endpoint was the proportion of patients achieving high-quality glycemic control [time in range(TIR) > 70%, coefficient of variation (CV) < 36%, and no hypoglycemia]. Secondary endpoints included continuous glucose monitoring (CGM)-derived metrics, insulin requirements, and insulin resistance and β-cell function indices.
RESULTS
Compared with controls, the IDegLira group showed higher TIR (84.03% vs. 74.67%, P = 0.007) and lower time above range (TBR) (P = 0.005). Glycemic variability indices, including mean glucose(MG) (8.26 vs. 9.74 mmol/L), were significantly improved (all P ≤ 0.003). The IDegLira group required less insulin (37.95 vs. 41.59 U/d, P = 0.03), achieved glycemic targets faster (3.1 vs. 5.0 days, P < 0.001), and had a higher rate of high-quality glycemic control (65.1% vs. 36.5%, P = 0.001). Short-term reductions in insulin resistance and improvements in β-cell function indices were also observed (all P ≤ 0.001).
CONCLUSION
IDegLira combined with insulin aspart provides superior short-term glycemic control compared with insulin glargine plus insulin aspart in overweight or obese patients with T2DM, with improved glycemic stability, reduced insulin requirements, faster target attainment, and favorable short-term metabolic changes.