Insulin plus incretin: A glucose-lowering strategy for type 2-diabetes

Table 1 Published clinical trials with glucagon-like peptide-1 receptor agonists added to ongoing insulin therapy

		Exenatide BID	Lixisenatide
Ref		56	58	59	60
Number of patients		259	495	446	311
Duration (wk)		30	24	24	24
HbA1c	Baseline	8.3 ± 0.9	8.4 ± 0.9	7.6 ± 0.5	8.5 ± 0.7
	Change	-1.7 (-1.9, -1.6)	-0.7 ± 0.1	-0.7 ± 0.1	-0.8 ± 0.2
	Baseline comparator	8.5 ± 1.0	8.4 ± 0.8	7.6 ± 0.5	8.5 ± 0.8
	Change comparator	-1.0 (-1.2, -0.9)	-0.4 ± 0.1	-0.4 ± 0.1	+0.1 ± 0.2
FPG (mmol/L)	Baseline	7.9 ± 2.1	8.1 ± 2.8	6.6 ± 1.7	7.8 ± 2.2
	Change	-1.6 (-1.9, -1.3)	-0.6 ± 0.2	-0.3 ± 0.2	-0.4 ± 0.3
	Baseline comparator	8.3 ± 2.3	8.0 ± 2.7	6.7 ± 2.0	7.7 ± 2.3
	Change comparator	-1.5 (-1.8, -1.2)	-0.6 ± 0.3	-0.5 ± 0.2	0.3 ± 0.3
Hypoglycemia	GLP-1RA	1.41	2062	283	423; 334
	Comparator	1.21	5222	223	243; 284
Body weight	Baseline	95 ± 20	89 ± 21	88 ± 22	66 ± 13
	Change	-1.8 (-2.4, -1.1)	-1.8 ± 0.2	0.3 ± 0.3	-0.4
	Baseline comparator	93 ± 21	88 ± 20	87 ± 21	66 ± 12
	Change comparator	1.0 (0.2, 1.7)	-0.5 ± 0.3	1.2 ± 0.3	+0.1

Insulin glargine was used in all studies. Occurrence of hypoglycemia was reported as number of episodes per patient year¹, number of events² or as percentage of patients with at least one hypoglycemic episode³. One study also reported percentage of patients not on sulfonylurea who experienced at least one hypoglycemic episode⁴. Variation in baseline is SD, variation in effect is SE. Variation within parenthesis is the 95%CI. FPG: Fasting glucose; GLP-1: Glucagon-like peptide-1; HbA1c: Hemoglobin A1c.