In a nutshell
This study compared the safety and effectiveness of lixisenatide (Lyxumi) and liraglutide (Victoza) in type 2 diabetes.
Some background
Lifestyle changes, such as changes to diet and exercise, and oral antidiabetic medications are first-line treatments for in type 2 diabetes (T2D). Sometimes, these are not enough to improve glycemic (blood glucose) control, and insulin must be added.
Even with insulin treatment, blood sugar levels may become too high after meals. In this instance, other medications that increase insulin secretion through the urine may be added to help improve blood glucose control. Lixisenatide and liraglutide are two examples.
Methods & findings
The current study examined whether lixisenatide and liraglutide could be safely and effectively added to insulin therapy. 142 patients with T2D were included in this study. All groups were treated with insulin glargine, a long acting insulin, once a day. Patients were randomly assigned treatment with an injection of either lixisenatide 20 mg, liraglutide 1.2 mg, or liraglutide 1.8 mg once daily. Some patients also needed to take metformin (Glucophage), an oral drug that suppresses glucose production by the liver.
All patients were given two test meals at the start and end of the study. HbA1c levels (average blood glucose levels over the past 3 months) were measured along with the speed at which the stomach empties after eating.
Lixisenatide had a greater effect on delaying stomach emptying and lowering glucose levels immediately after food. Liraglutide was more effective at lowering fasting plasma glucose levels and the effects lasted longer than lixisenatide.
The average HbA1c levels decreased in all groups to approximately 6.1% and all groups reported weight loss. Liraglutide 1.8 mg led to the largest weight loss, an average of 2.4 kg, compared to 1.6 kg in those receiving lixisenatide.
The most common side effects were hypoglycemia (low blood sugar levels) and nausea. Nausea was experienced by 18.8% of patients taking lixisenatide, 17% of those taking 1.2 mg liraglutide and 23.4% of people taking 1.8 mg liraglutide.
The bottom line
This study suggested that addinga GLP-1 receptor agonist like liraglutide or lixisenatide to insulin therapy may be beneficial in reducing HbA1c and improving glycemic control.
The fine print
Lixisenatide is not yet licensed by the FDA but may become available in 2015.
What’s next?
Talk to your physician if you are concerned about your HbA1c level.
Published By :
Diabetes Care
Date :
Apr 17, 2015
