AIM To investigate the efficacy and safety of initiating insulin degludec/liraglutide (IDegLira) in patients with type 2 diabetes (T2D) who had discontinued pretrial sulphonylureas (SUs) or dipeptidyl peptidase-4 inhibitors (DPP4is) versus patients not previously treated with these regimens. MATERIALS AND METHODS In DUAL II, patients with T2D uncontrolled on basal insulin and metformin ± SU/glinides were randomized to insulin degludec or IDegLira (both capped at 50 U). In DUAL IX, patients were randomized to insulin glargine U100 (no maximum dose) or IDegLira, as add-on to sodium-glucose co-transporter-2 inhibitors ± oral antidiabetic drugs. In this post hoc analysis, patients were grouped according to pretrial use of SU (DUAL II) or DPP4i (DUAL IX). RESULTS Regardless of pretrial SU/DPP4i use, IDegLira was favourable versus insulin comparators with respect to change in HbA1c and body weight. Lower hypoglycaemia rates and comparable end-of-trial daily insulin dose were achieved with IDegLira, regardless of pretrial regimen. There was no clinically relevant increase in mean self-measured blood glucose in the early weeks after IDegLira initiation. There was no statistically significant interaction between the randomized treatments and previous SU/DPP4i use. CONCLUSIONS IDegLira was more favourable compared with degludec or glargine U100 in terms of change in HbA1c and body weight, regardless of antecedent treatment. Clinicians should be aware of a potential transient rise in self-measured blood glucose when transitioning therapy in patients. This shows that SUs/DPP4is can be safely discontinued, without deterioration in glycaemic control when initiating IDegLira, allowing a simplified treatment regimen.

中文翻译：

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即使在开始degludec / liraglutide治疗后停用磺脲类药物或二肽基肽酶-4抑制剂的患者中，也可维持degludec / liraglutide胰岛素的益处：DUAL II和DUAL IX试验的事后分析。

目的探讨胰岛素二代去甲磺脲类药物（SUs）或二肽基肽酶-4抑制剂（DPP4is）停用的2型糖尿病（T2D）患者相对于先前未接受过这种方案治疗的患者，开始胰岛素degludec /利拉鲁肽（IDegLira）的有效性和安全性。材料和方法在DUAL II中，将不受基础胰岛素和二甲双胍±SU /格列奈特控制的T2D患者随机分配至胰岛素地格列汀或IDegLira（均以50 U为上限）。在DUAL IX中，患者被随机分配至甘精胰岛素U100（无最大剂量）或IDegLira，作为钠-葡萄糖共转运蛋白2抑制剂（口服抗糖尿病药）的补充。在此事后分析中，根据SU（DUAL II）或DPP4i（DUAL IX）的审前使用对患者进行分组。结果不论使用SU / DPP4i，在HbA1c和体重的变化方面，IDegLira优于胰岛素比较剂。无论采用何种预治疗方案，IDegLira均可降低较低的低血糖发生率，并具有相当的试验终末每日胰岛素剂量。在IDegLira启动后的最初几周，平均自我测量的血糖没有临床相关的升高。随机治疗与以前的SU / DPP4i使用之间没有统计学上的显着相互作用。结论IDegLira与degludec或甘精氨酸U100相比，无论HbA1c和体重的变化如何，无论采用何种前处理方法，都更有利。当过渡患者治疗时，临床医生应意识到自我测量血糖的潜在短暂升高。这表明可以安全地终止SUs / DPP4is，