GLP‐1 receptor agonist added to insulin versus basal‐plus or basal‐bolus insulin therapy in type 2 diabetes: A systematic review and meta‐analysis
Abstract
Background Current guidelines recommend that antihyperglycaemic treatment in patients with type 2 diabetes not achieving the HbA 1c target on basal insulin should be intensified with a glucagon-like peptide-1 receptor agonist (GLP-1RA) or basal-plus/basal-bolus (BP/BB) insulin regimen. We conducted a systematic review and meta-analysis to compare the effects of GLP-1RA/insulin combinations versus BP/BB. Methods The review was registered on PROSPERO (CRD42017079547). PubMed, Scopus, CENTRAL, and ClinicalTrials.gov were searched until July 2018. All randomized controlled trials (RCTs) reporting HbA 1c , body weight, daily insulin dose, hypoglycaemic events, and discontinuation due to lack of efficacy were included. A subgroup analysis on different combinations of GLP-1RA and insulin was performed. Results Out of 1885 retrieved papers, 13 RCTs were included in the review. Compared with BP/BB, GLP-1RA/insulin combinations were associated with a similar HbA 1c reduction (Δ = -0.06%; 95% confidence interval [CI], -0.14 to 0.02; P = 0.13; I 2 = 52%), greater weight loss (Δ = -3.72 kg; 95% CI, -4.49 to -2.95; P 2 = 89%), and lower incidence of hypoglycaemic events (relative risk [RR] = 0.46; 95% CI, 0.38-0.55; P 2 = 99%). The daily insulin dosage among GLP-1RA/insulin users was 30.3 IU/day (95% CI, -41.2 to -19.3; P 2 = 94%), lower than with BP/BB. No difference was found for discontinuation due to lack of efficacy. Conclusions The present review supports treatment intensification wi…
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GLP-1 RAs or dual GIP and GLP-1 RAs lower the risks of hypoglycemia and weight gain associated with insulin therapy.
“to lower the risks of hypoglycemia and weight gain associated with insulin therapy (131,172).”
From 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes—2025 (2025) · cites this paper as [172]
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Effect of medication adherence on clinical outcomes in type 2 diabetes: analysis of the SIMPLE study
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- Authors
- Castellana, M., Cignarelli, A., Brescia, F., Laviola, L., & Giorgino, F.
- Affiliations
- University of Bari Aldo Moro (IT)
- Corresponding author
- Giorgino, Francesco
- Venue
- Diabetes/Metabolism Research and Reviews
- Publisher
- Wiley
- Published
- 2018-10-18
- Volume
- 35
- Issue
- 1
- Pages
- e3082-e3082
- ISSN
- 1520-7552 (ISSN-L)
- 1520-7560
- OpenAlex
- W2894901807
- Cited by
- 84
- References
- 6
- Citations by year
- 2026: 6 · 2025: 9 · 2024: 6 · 2023: 12 · 2022: 13 · 2021: 13 · 2020: 13 · 2019: 11
- FWCI
- 1.42
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes/Metabolism Research and Reviews (publishedVersion)
- PubMed (publishedVersion)
- CINECA IRIS Institutional Research Information System (University of Bari Aldo Moro) (submittedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- GLP-1 receptor agonists, multiple daily insulin injections, type 2 diabetes, insulin intensification, HbA1c, weight loss, hypoglycemia, insulin dose reduction, treatment discontinuation, glycemic control, body weight
- MeSH terms
- Glucagon-Like Peptide-1 Receptor Agonists, Blood Glucose, Diabetes Mellitus, Type 2, Drug Therapy, Combination, Humans, Hypoglycemic Agents, Insulin, Treatment Outcome
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