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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EThe 2012 American Diabetes Association\/European Association for the Study of Diabetes position statement for the management of hyperglycemia recommends, as 1 of the 3-drug combinations, the addition of glucagon-like peptide\u20131 receptor agonists to basal insulin analogs (or conversely, insulin to GLP-1 receptor agonists) after initial therapy with metformin. This article presents the results of the Effect of Liraglutide Versus Placebo When Added to Basal Insulin Analogues With or Without Metformin in Subjects With Type 2 Diabetes trial [LIRA-ADD2BASAL; \u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT01617434\u0026amp;atom=%2Fspmdc%2F14%2F32%2F13.atom\u0022\u003ENCT01617434\u003C\/a\u003E], comparing the efficacy and safety of liraglutide versus placebo when added to basal insulin analogs.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EHyperglycemia\/Hypoglycemia\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes \u0026amp; Endocrinology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes Mellitus\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EEndocrinology\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes \u0026amp; Metabolic Syndrome\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EHyperglycemia\/Hypoglycemia\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes \u0026amp; Endocrinology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes Mellitus\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EJorma Lahtela, MD, PhD, Tampere University Hospital, Tampere, Finland, presented the results of the randomized, placebo-controlled Effect of Liraglutide Versus Placebo When Added to Basal Insulin Analogues With or Without Metformin in Subjects With Type 2 Diabetes trial [LIRA-ADD2BASAL; \u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT01617434\u0026amp;atom=%2Fspmdc%2F14%2F32%2F13.atom\u0022\u003ENCT01617434\u003C\/a\u003E; Lahtela J et al. EASD 2014 (Oral Presentation 37)], comparing the efficacy and safety of liraglutide versus placebo when added to basal insulin analogs (insulin detemir or insulin glargine) in patients with type 2 diabetes mellitus (T2DM). Liraglutide 1.8 mg added to basal insulin analogs significantly improved glycemic control and reduced weight and blood pressure compared with placebo. Typical gastrointestinal symptoms and nonsevere hypoglycemia were reported more frequently with liraglutide than with placebo.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EThe 2012 American Diabetes Association\/European Association for the Study of Diabetes position statement for the management of hyperglycemia recommends, as 1 of the 3-drug combinations, the addition of glucagon-like peptide\u20131 (GLP-1) receptor agonists to basal insulin analogs (or conversely, insulin to GLP-1 receptor agonists) after initial therapy with metformin [Inzucchi SE et al. \u003Cem\u003EDiabetes Care\u003C\/em\u003E. 2012]. The goal of this trial was to establish the superior efficacy and acceptable safety of liraglutide, compared with placebo, when added to preexisting basal insulin analog with or without metformin in patients with inadequately controlled T2DM.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EPatients were randomized 1:1 to receive once daily liraglutide 1.8 mg or placebo added to preexisting treatment for 26 weeks in this multicenter, multinational, double-blind, parallel-group design study (\u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E). Patients with T2DM, aged 18 to 80 years, with body mass indexes (BMIs) of 20 to 45 kg\/m\u003Csup\u003E2\u003C\/sup\u003E and HbA\u003Csub\u003E1c\u003C\/sub\u003E level of 7% to 10%, and on stable insulin analog dose \u2265 20 U\/d with or without stable metformin \u2265 1500 mg\/d were eligible for participation. Insulin adjustments above the pretrial dose were not allowed.\u003C\/p\u003E\u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/32\/13\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Study Design of LIRA-ADD2BASAL\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-181344242\u0022 data-figure-caption=\u0022Study Design of LIRA-ADD2BASAL\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/32\/13\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/32\/13\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/32\/13\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/12025\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption attrib\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-5\u0022 class=\u0022first-child\u0022\u003EStudy Design of LIRA-ADD2BASAL\u003C\/p\u003E\n         \u003Cq class=\u0022attrib\u0022 id=\u0022attrib-1\u0022\u003EBMI, body mass index.\u003C\/q\u003E\u003Cq class=\u0022attrib\u0022 id=\u0022attrib-2\u0022\u003EReproduced with permission from J Lahtela, MD.\u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-6\u0022\u003EA total of 450 patients were randomized in the trial, with a mean duration of diabetes of 12.1 years, a mean BMI of 32 kg\/m\u003Csup\u003E2\u003C\/sup\u003E, and a geometric mean pretrial insulin dose of 40.5 U. The mean baseline HbA\u003Csub\u003E1c\u003C\/sub\u003E level was similar between groups (8.2% liraglutide, 8.3% placebo).\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EThree hundred sixty-five patients completed the trial. The primary end point was the change in HbA\u003Csub\u003E1c\u003C\/sub\u003E from baseline to week 26. Patients taking liraglutide had a greater decrease in HbA\u003Csub\u003E1c\u003C\/sub\u003E from baseline than those taking placebo (\u22121.3 and \u22120.11, respectively; \u003Ca id=\u0022xref-fig-2-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F2\u0022\u003EFigure 2\u003C\/a\u003E), and more liraglutide recipients reached HbA\u003Csub\u003E1c\u003C\/sub\u003E \u0026lt; 7.0% (59.2% vs 14.0%) and HbA\u003Csub\u003E1c\u003C\/sub\u003E \u2264 6.5% (42.9% vs 3.6%) (\u003Cem\u003EP\u003C\/em\u003E \u0026lt; .0001 for both) despite using a lower mean estimated daily dose of basal insulin analog compared with placebo (35.8 vs 40.0 U).\u003C\/p\u003E\u003Cdiv id=\u0022F2\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/32\/13\/F2.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Change in HbA1c in Patients Taking Liraglutide Versus Placebo Added to Basal Insulin Analogs\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-181344242\u0022 data-figure-caption=\u0022\u0026amp;lt;div xmlns=\u0026amp;quot;http:\/\/www.w3.org\/1999\/xhtml\u0026amp;quot;\u0026amp;gt;Change in HbA\u0026amp;lt;sub\u0026amp;gt;1c\u0026amp;lt;\/sub\u0026amp;gt; in Patients Taking Liraglutide Versus Placebo Added to Basal Insulin Analogs\u0026amp;lt;\/div\u0026amp;gt;\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 2.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/32\/13\/F2.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/32\/13\/F2.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 2.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/32\/13\/F2.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/12026\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption attrib\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 2.\u003C\/span\u003E \n            \u003Cp id=\u0022p-8\u0022 class=\u0022first-child\u0022\u003EChange in HbA\u003Csub\u003E1c\u003C\/sub\u003E in Patients Taking Liraglutide Versus Placebo Added to Basal Insulin Analogs\u003C\/p\u003E\n         \u003Cq class=\u0022attrib\u0022 id=\u0022attrib-3\u0022\u003EEstimated means \u00b1 standard errors, from mixed model for repeated measurements. ETD, estimated treatment difference.\u003C\/q\u003E\u003Cq class=\u0022attrib\u0022 id=\u0022attrib-4\u0022\u003EReproduced with permission from J Lahtela, MD.\u003C\/q\u003E\u003Cq class=\u0022attrib\u0022 id=\u0022attrib-5\u0022\u003E\n            \u003Csup\u003Ea\u003C\/sup\u003E95% CI, \u22121.39 to \u22120.99 (\u003Cem\u003EP\u003C\/em\u003E \u0026lt; .0001).\u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-9\u0022\u003EPatients taking liraglutide also achieved greater decreases from baseline in fasting plasma glucose (FPG; \u221226 and \u22123 mg\/dL, respectively), incremental postprandial self-measured plasma glucose (\u221217 and \u22127 mg\/dL, respectively), body weight (\u003Ca id=\u0022xref-fig-3-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F3\u0022\u003EFigure 3\u003C\/a\u003E), systolic blood pressure (SBP) (\u22126 and \u22121 mm Hg, respectively), and lipids.\u003C\/p\u003E\u003Cdiv id=\u0022F3\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/32\/13\/F3.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Change in Weight in Patients Taking Liraglutide Versus Placebo Added to Basal Insulin Analogs\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-181344242\u0022 data-figure-caption=\u0022Change in Weight in Patients Taking Liraglutide Versus Placebo Added to Basal Insulin Analogs\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 3.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/32\/13\/F3.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/32\/13\/F3.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 3.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/14\/32\/13\/F3.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/12027\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption attrib\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 3.\u003C\/span\u003E \n            \u003Cp id=\u0022p-10\u0022 class=\u0022first-child\u0022\u003EChange in Weight in Patients Taking Liraglutide Versus Placebo Added to Basal Insulin Analogs\u003C\/p\u003E\n         \u003Cq class=\u0022attrib\u0022 id=\u0022attrib-6\u0022\u003EEstimated mean change from baseline to week 26, from mixed model for repeated measurements. ETD, estimated treatment difference.\u003C\/q\u003E\u003Cq class=\u0022attrib\u0022 id=\u0022attrib-7\u0022\u003EReproduced with permission from J. Lahtela, MD.\u003C\/q\u003E\u003Cq class=\u0022attrib\u0022 id=\u0022attrib-8\u0022\u003E\n            \u003Csup\u003Ea\u003C\/sup\u003E95% CI, \u22123.85 to \u22122.37 (\u003Cem\u003EP\u003C\/em\u003E \u0026lt; .0001).\u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-11\u0022\u003ENausea and vomiting occurred more frequently with liraglutide than placebo (22% vs 3% and 9% vs 1%, respectively). Minor hypoglycemia (plasma glucose \u0026lt; 56 mg\/dL) occurred in 18% and 12% of liraglutide and placebo recipients, respectively. No severe hypoglycemic events (requiring assistance of another person) were reported during this trial.\u003C\/p\u003E\u003Cp id=\u0022p-12\u0022\u003EIn summary, the addition of liraglutide to insulin detemir or insulin glargine with or without metformin significantly improved glycemic control, which was attributed to the effect of liraglutide on both FPG and postprandial glucose levels. Additionally, liraglutide induced greater weight loss and reductions in SBP and selected lipids compared with placebo. Adverse effects were similar to those seen in other trials of liraglutide.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/32\/13.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzorq2\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzorq2\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}