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      Physicians’ real-world experience with IDegLira: results of a European survey

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          Abstract

          Objective

          This study aimed to build on the current clinical findings and investigate physicians’ experiences and level of satisfaction in using insulin degludec/liraglutide (IDegLira) to treat patients with type 2 diabetes (T2D).

          Research design and methods

          This multicountry, European online survey included respondents from primary (n=132) and secondary (n=103) care and examined physicians’ use, confidence and satisfaction with IDegLira. To standardize responses, 24 of 28 questions pertained to an ‘average patient’ with T2D who has no major comorbidities, aged 35–70 years, with average cognitive ability/normal mental status and body mass index ≥25 kg/m 2.

          Results

          The majority (70%) of respondents prescribe IDegLira in the same visit they first mention it, with uncontrolled glycated hemoglobin (HbA1c) (44%) and weight gain (22%) being the most common reasons. On average, physicians reported that patients weighed 95 kg and the HbA1c level was 9.0% at initiation. Physicians also reported the average HbA1c target set was 7.1%; 76% of patients achieved their target. On average, patients achieved their HbA1c target in <6 months, and the average dose of IDegLira in patients in glycemic control was 28 dose steps. Respondents were more satisfied with IDegLira than basal-bolus therapy across all parameters assessed, including reaching HbA1c targets (59%), number of injections (77%) and avoiding weight gain (84%). Correspondingly, 77% of physicians reported that IDegLira had more potential to improve patient motivation compared with basal-bolus to reach target blood glucose levels.

          Conclusions

          Real-world experience of IDegLira is consistent with previous trials/studies, with no major differences between primary and secondary care. Importantly, the majority of respondents were more/much more satisfied with IDegLira than with basal-bolus therapy.

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          Most cited references26

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          Efficacy and safety of a fixed-ratio combination of insulin degludec and liraglutide (IDegLira) compared with its components given alone: results of a phase 3, open-label, randomised, 26-week, treat-to-target trial in insulin-naive patients with type 2 diabetes.

          A fixed-ratio combination of the basal insulin analogue insulin degludec and the glucagon-like peptide-1 (GLP-1) analogue liraglutide has been developed as a once-daily injection for the treatment of type 2 diabetes. We aimed to compare combined insulin degludec-liraglutide (IDegLira) with its components given alone in insulin-naive patients.
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            Clinical inertia to insulin initiation and intensification in the UK: A focused literature review.

            Achieving tight glycaemic control early following the diagnosis of type 2 diabetes is key to optimising clinical outcomes, yet many patients and clinicians are reluctant to initiate and intensify insulin therapy. Reasons for this arise primarily from a lack of time, clinical expertise and patient understanding. However, meaningful progress can be achieved with self-management educational programmes soon after diagnosis. Clinician education and training, along with easy-to-use and well-tolerated therapies (for example, those carrying a low risk of hypoglycaemia and/or avoiding weight gain), may also increase the likelihood of patient adherence.
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              Contribution of liraglutide in the fixed-ratio combination of insulin degludec and liraglutide (IDegLira).

              Insulin degludec/liraglutide (IDegLira) is a novel combination of insulin degludec (IDeg) and liraglutide. This trial investigated the contribution of the liraglutide component of IDegLira versus IDeg alone on efficacy and safety in patients with type 2 diabetes.
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                Author and article information

                Journal
                BMJ Open Diabetes Res Care
                BMJ Open Diabetes Res Care
                bmjdrc
                bmjdrc
                BMJ Open Diabetes Research & Care
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2052-4897
                2018
                14 June 2018
                : 6
                : 1
                : e000531
                Affiliations
                [1 ] departmentDepartment of Diabetes , Endocrinology and Clinical Pharmacology, Glasgow Royal Infirmary , Glasgow, UK
                [2 ] IQVIA , Rotkreuz, Switzerland
                [3 ] Novo Nordisk A/S , Søborg, Denmark
                [4 ] Citydiabetes , Stockholm, Sweden
                Author notes
                [Correspondence to ] Dr Russell Drummond; russell.drummond@ 123456glasgow.ac.uk
                Article
                bmjdrc-2018-000531
                10.1136/bmjdrc-2018-000531
                6014227
                0c65a9a4-b4d5-4e96-9f1f-d285ad30649b
                © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

                History
                : 05 March 2018
                : 15 May 2018
                Categories
                Clinical Care/Education/Nutrition
                1506
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                observational study,basal,insulin treatment in type,addtrackchanges">2 diabetes,glp-1

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