A real-world study assessing the efficacy and safety of switching from basal bolus insulin therapy to once daily iGlarLixi in people with type 2 diabetes mellitus: soli de-escalation

Aim: To compare glycemic outcomes in adults with type 2 diabetes mellitus (T2DM) switching from basal-bolus insulin (BBI) to once-daily iGlarLixi. Materials and methods: This real-world retrospective observational study analyzed electronic medical records of adults (≥18 years) with T2DM who switched from BBI to iGlarLixi (01/01/2017–30/09/2022) from the US Optum Market Clarity® database. Primary endpoint was HbA1c change at 6 months after switching to iGlarLixi. Secondary endpoints included HbA1c change at 3 months and body weight change and hypoglycemic events at 6 months. Subgroup analyses included individuals aged ≥65 years and those with baseline HbA1c ≥7 % (53 mmol/mol). Results: Participants (N = 372, mean age: 58.9 years; ≥65 years old: 30.6 %; females: 60.5 %) showed significant HbA1c reduction (0.9 %; p < 0.0001) from 9.6 % at baseline to 8.6 % at 6 months. In participants ≥65 years and those with HbA1c ≥7 %, HbA1c decreased from 9.3 % and 9.8 % to 8.4 % and 8.8 % at 6 months, respectively. The proportion of participants achieving HbA1c <7 % (53 mmol/mol) doubled from 7.0 % to 14.8 % at 6 months after switching to iGlarLixi. Hypoglycemia incidence and event rates decreased across all populations. Conclusions: Switching from BBI to once-daily iGlarLixi improved glycemic control with significant HbA1c reduction and fewer hypoglycemic events.