Switching from MDI to iGlarLixi kept HbA1c similar and lowered weight
Key takeaway:
In adults with type 2 diabetes using multiple daily injections, switching to once-daily iGlarLixi kept HbA1c about the same over 24 weeks while lowering weight, insulin dose, and some hyperglycemia measures.
Study at a glance
What was studied
Switching adults with type 2 diabetes from MDI insulin to once-daily iGlarLixi
Study type
Randomized Controlled Trials (RCTs)
duration
Medium-Term (3–12 mo)
Intervention
Insulin Glargine-Lixisenatide dosis
Outcomes
HbA1c, Body weight, BMI, Daily insulin dose, Fasting Plasma Glucose, Postprandial glucose, Time in level 2 hyperglycemia, Glycemia risk index, Treatment satisfaction, Hypoglycemia events
Funding
Industry sponsored
Main effects
HbA1c ↔ stayed similar between iGlarLixi and MDI over 24 weeks
Body weight ↓ more with iGlarLixi than with continued MDI
Total daily insulin dose ↓ substantially after switching to iGlarLixi
Marked hyperglycemia time ↓ and glycemia risk index ↓ with iGlarLixi
Evidence Summary
| Intervention | Outcome | Measured Change | Study Effect |
|---|---|---|---|
 Insulin Glargine-Lixisenatide dosis (Medications) |  BMI (Weight & Anthropometrics) | Decrease | Strong |
Insulin Glargine-Lixisenatide dosis (Medications) | Body weight (Weight & Anthropometrics) | Decrease | Strong |
Insulin Glargine-Lixisenatide dosis (Medications) |  Daily insulin dose (Glycemic Control) | Decrease | Strong |
Insulin Glargine-Lixisenatide dosis (Medications) | Fasting Plasma Glucose (Glycemic Control) | Decrease | Limited |
Insulin Glargine-Lixisenatide dosis (Medications) | Glycemia risk index (Glycemic Control) | Decrease | Strong |
Insulin Glargine-Lixisenatide dosis (Medications) | HbA1c (Glycemic Control) | Uncertain | Limited |
Insulin Glargine-Lixisenatide dosis (Medications) |  Hypoglycemia events (Safety) | Decrease | Mixed |
Insulin Glargine-Lixisenatide dosis (Medications) | Postprandial glucose (Glycemic Control) | Uncertain | Limited |
Insulin Glargine-Lixisenatide dosis (Medications) | Time in level 2 hyperglycemia (Glycemic Control) | Decrease | Strong |
Insulin Glargine-Lixisenatide dosis (Medications) |  Treatment satisfaction (Patient-Reported) | Increase | Mixed |
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Evidence Suggest
- The between-group difference in HbA1c change was -0.12%, which suggests similar overall glycemic control.
- Body weight fell 4.19 kg more with iGlarLixi than with continued MDI.
- Total daily insulin dose changed by -28.57 IU in favor of iGlarLixi.
- Time spent above 13.9 mmol/L and glycemia risk index both improved more with iGlarLixi.
Who this applies to
These results apply most directly to adults with type 2 diabetes who were already using multiple daily insulin injections, had preserved fasting C-peptide, and were treated in specialist diabetes care. The average participant was older, had long-standing diabetes, and had obesity or overweight.
Keep in Mind
This study tested treatment simplification in a selected group, not in everyone with type 2 diabetes on insulin. The main glycemic outcome was similar between groups, so the benefit came more from lower treatment burden, lower insulin dose, weight loss, and some sensor-based glucose measures. Because the trial was open label and modest in size, the findings are best used as supportive rather than definitive for all patients.
Between the Lines
- The study was open label, so patient-reported outcomes were more vulnerable to bias.
- Only 90 participants were analyzed.
- The trial was conducted in one country and all participants were white.
- Most participants were men, which limits how broadly the findings may apply.
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Journal Reference
Novodvorsky P, Thieme L, Lankova I, et al. Insulin therapy DE-intensificAtion with iGlarLixi: A phase 4, open-label, parallel-group randomised controlled trial. Diabetes Obes Metab. 2026;28(3):1817-1825. doi:10.1111/dom.70362
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