Insulin glargine/lixisenatide enhances T2DM control in real world

Switching to insulin glargine/lixisenatide effectively lowers glucose levels in overweight adults with uncontrolled type 2 diabetes mellitus (T2DM), according to real-world data.

At the 3-month follow-up, mean HbA1c significantly decreased from 9.3 percent at baseline to 7.83 percent (p<0.001). A modest reduction in BMI was observed, from 29.91 to 29.62 kg/m² (p=0.049), while weight decreased from 76.89 to 75.85 kg (p=0.001). [ATTD-Asia 2025, abstract EPV047]

The analysis included 50 adult T2DM patients (mean age 60.6 years) treated at a tertiary care hospital in India. The patients had a baseline BMI of >25 kg/m² and HbA1c of >7.5 percent despite treatment with monotherapy (24 percent), dual therapy (36 percent), or triple therapy (40 percent).

The results of the study supports the initiation of insulin glargine/lixisenatide in patients with HbA1c >7.5 percent who are on dual or triple-therapy, said first study author Dr Ashwin Karuppan from Gleneagles Healthcity in Chenai, India.

“There was no increase in the BMI of the patients in the study even though they were taking insulin,” with insulin glargine/lixisenatide even associated with a reduction in BMI and weight, Karuppan noted.

The finding on BMI and weight holds clinical importance, given that starting insulin, which is an anabolic hormone, can cause weight gain, added Karuppan. “Preventing weight gain is essential in optimizing glycaemic control,” making insulin glargine/lixisenatide suitable for T2DM patients with obesity.”

Finally, insulin glargine/lixisenatide shows good compatibility in all age groups, he said, noting that the age of the patients in the study ranged from 27 years to 80 years.

Regular monitoring

The glucose-lowering drug contains a fixed-ratio combination of insulin glargine (100 units/mL), a basal insulin, and lixisenatide (33 mcg/mL), a glucose-like peptide-1 receptor agonist (GLP-1RA). Insulin glargine/lixisenatide “has been introduced for T2DM patients inadequately controlled on basal insulin or GLP-1RA,” noted Karuppan.

When initiating the medication, “regular HbA1c and weight monitoring is recommended within the first few months to assess responsiveness and guide dosage adjustments,” he added.

While the current study evaluated the effect of insulin glargine/lixisenatide on HbA1c, BMI, and weight in patients treated in routine care, additional studies are needed to establish the medication’s long-term effects and assess patient adherence, Karuppan said.