TY - JOUR

T1 - Deintensification of basal-bolus insulin therapy by switching to a fixed-ratio combination of insulin glargine and lixisenatide in patients with type 2 diabetes

AU - Klimontov, Vadim V.

AU - Yakovleva, Sophia A.

AU - Koroleva, Elena A.

AU - Bulumbaeva, Dinara M.

AU - Mavlianova, Kamilla R.

AU - Raeisinezhad, Karsa

N1 - Klimontov V.V., Yakovleva S.A., Koroleva E.A., Bulumbaeva D.M., Mavlianova K.R., Raisinezhad K. Deintensification of basal-bolus insulin therapy by switching to a fixed-ratio combination of insulin glargine and lixisenatide in patients with type 2 diabetes. Diabetes mellitus. 2025;28(5):424-432. (In Russ.) https://doi.org/10.14341/DM13381 The study was carried out using funds from a state assignment of the RICEL - Branch of IC&G SB RAS.

PY - 2025

Y1 - 2025

N2 - BACKGROUND: Deintensification of basal-bolus insulin therapy (BBIT) with simplification of the treatment regimen is a pos-sible and necessary therapeutic strategy for some patients with type 2 diabetes (T2D). One of the options for deintensification is the transition to fixed combination of insulin glargine/lixisenatide (iGlarLixi). AIM: To determine the efficacy and safety of deintensification of BBIT in hospitalized patients with T2D by switching to iGlarLixi under continuous glucose monitoring (CGM). MATERIALS AND METHODS: Design: single-center, comparative, observational study in real-world settings. A total of 283 T2D patients on BBIT were included, 118 subjects underwent BBIT deintensification under CGM control according to clinical indications, 165 patients continued BBIT. Thirty patients were re-examined one year after deintensification. Time In target Range (TIR), Time Above Range (TAR), Time Below Range (TBR), as well as Coefficient of Variation (CV), Mean Ampli-tude of Glycemic Excursions (MAGE), Lability Index (LI), and Mean Absolute Glucose rate of change (MAG) were estimated. Endogenous insulin secretion was assessed by fasting and 2-hour postprandial C-peptide levels. The estimated glucose disposal rate (eGDR) was used as a measure of insulin sensitivity. RESULTS: The groups were similar in age, diabetes duration, glycated hemoglobin (HbA1c) and eGDR. Body mass index (BMI) and C-peptide levels were higher, while the duration of insulin therapy and initial daily insulin dose (DID) were lower in patients of the deintensification group (all p≤0.0004). During deintensification, DID was reduced (from 64 to 30 U/day, p13.9 mmol/L), CV, MAGE and MAG were lower (all p

AB - BACKGROUND: Deintensification of basal-bolus insulin therapy (BBIT) with simplification of the treatment regimen is a pos-sible and necessary therapeutic strategy for some patients with type 2 diabetes (T2D). One of the options for deintensification is the transition to fixed combination of insulin glargine/lixisenatide (iGlarLixi). AIM: To determine the efficacy and safety of deintensification of BBIT in hospitalized patients with T2D by switching to iGlarLixi under continuous glucose monitoring (CGM). MATERIALS AND METHODS: Design: single-center, comparative, observational study in real-world settings. A total of 283 T2D patients on BBIT were included, 118 subjects underwent BBIT deintensification under CGM control according to clinical indications, 165 patients continued BBIT. Thirty patients were re-examined one year after deintensification. Time In target Range (TIR), Time Above Range (TAR), Time Below Range (TBR), as well as Coefficient of Variation (CV), Mean Ampli-tude of Glycemic Excursions (MAGE), Lability Index (LI), and Mean Absolute Glucose rate of change (MAG) were estimated. Endogenous insulin secretion was assessed by fasting and 2-hour postprandial C-peptide levels. The estimated glucose disposal rate (eGDR) was used as a measure of insulin sensitivity. RESULTS: The groups were similar in age, diabetes duration, glycated hemoglobin (HbA1c) and eGDR. Body mass index (BMI) and C-peptide levels were higher, while the duration of insulin therapy and initial daily insulin dose (DID) were lower in patients of the deintensification group (all p≤0.0004). During deintensification, DID was reduced (from 64 to 30 U/day, p13.9 mmol/L), CV, MAGE and MAG were lower (all p

KW - basal-bolus insulin therapy

KW - continuous glucose monitoringglucose variability

KW - deintensification

KW - glucagon-like peptide-1

KW - iGlarLixi

KW - type 2 diabetes

KW - САХАРНЫЙ ДИАБЕТ 2 ТИПА

KW - БАЗИС-БОЛЮСНАЯ ИНСУЛИНОТЕРАПИЯ

KW - ДЕИНТЕНСИФИКАЦИЯ

KW - ГЛЮКАГОНОПОДОБНЫЙ ПЕПТИД-1

KW - ИГЛАРЛИКСИ

KW - НЕПРЕРЫВНЫЙ МОНИТОРИНГ ГЛЮКОЗЫ

KW - ВАРИАБЕЛЬНОСТЬ УРОВНЯ ГЛЮКОЗЫ

UR - https://www.scopus.com/pages/publications/105025701464

UR - https://www.elibrary.ru/item.asp?id=84266199

UR - https://www.mendeley.com/catalogue/0635337c-f1d4-3fa2-a0b7-cc17cab1347c/

U2 - 10.14341/DM13381

DO - 10.14341/DM13381

M3 - Article

VL - 28

SP - 424

EP - 432

JO - Diabetes Mellitus

JF - Diabetes Mellitus

SN - 2072-0351

IS - 5

M1 - 3

ER -