Xultophy, a combination of the long-acting (basal) insulin degludec and the glucagon-like peptide 1 receptor agonist liraglutide (IDegLira), is now available.

Xultophy is indicated for adults with type 2 diabetes and is combined with oral glucose-lowering drugs when these alone or when combined with basal insulin do not adequately control glycaemia.

Delegates to the American Diabetes Association’s recent meeting in Boston heard results from a 26‐week, open‐label trial, which enrolled 557 adults with type 2 diabetes that was uncontrolled with insulin glargine (20‐50U) alone. The patients, who had an HbA1c of 7‐10 per cent, received once‐daily insulin degludec and liraglutide (IDegLira) or continued up-titration with insulin glargine. Both groups received metformin.

Mean fasting plasma glucose decreased to a similar extent in both arms from 160mg/dL to 110mg/dL. Mean HbA1c decreased from 8.4 to 6.6 per cent with IDegLira, and from 8.2 to 7.1 per cent with insulin glargine. At the end of the study, 71.6 and 47.0 per cent of patients respectively showed mean HbA1c under 7 per cent. Weight decreased from 88.3kg to 86.9kg with IDegLira and increased from 87.3kg to 89.1kg with insulin glargine.

IDegLira was insulin sparing. Rates of confirmed (28.4 and 49.1 per cent respectively) and nocturnal hypoglycaemia (6.1 and 24.4 per cent respectively) were significantly lower with IDegLira than insulin glargine. Overall and serious adverse event rates were similar.