Possibilities of Combined Injection Therapy at the Start of Insulin Therapy in Patients with Type 2 Diabetes
The traditional option for starting insulin therapy in patients with type 2 diabetes mellitus (DM) is the start of basal insulin. However, this does not always lead to the achievement of the goals of glycemic control - only 30% of patients reach the target glycemic values 6 months after the initiation of insulin therapy. The correct use of basal insulin (especially adequate dose titration) allows to achieve the target fasting glucose, but does not always allow to achieve the target values of postprandial glycemia and, accordingly, the target level of HbA1c. To achieve the best results of therapy, it seems promising to use fixed ratio combinations of basal insulin and glucagon-like peptide 1 (GLP-1) receptor agonists, which, according to the results of clinical studies, allow 74% of patients to achieve HbA1c less than 7% at the start of insulin therapy, which is the target value for most patients with diabetes. The article presents data from clinical trials of the efficacy and safety of fixed ratio combination of insulin glargine and lixisenatide, confirming the advantage over the use of each of its components separately. A clinical case of the successful use of a fixed ratio combination of insulin glargine + lixisenatide on the start of insulin therapy inpatient with type 2 diabetes is presented.