Efficacy of lixisenatide in patients with type 2 diabetes: A post hoc analysis of patients with diverse ß-cell function in the GetGoal-M and GetGoal-S trials.

AIMS: To evaluate the impact of ß-cell function on the efficacy of lixisenatide, a once-daily prandial glucagon-like peptide-1 receptor agonist, in patients with type 2 diabetes (T2D). MATERIALS AND METHODS: In this post hoc analysis, patients from the Phase 3 GetGoal-M and GetGoal-S clinical trials randomized to lixisenatide 20µg once daily were stratified into quartiles by baseline ß-cell function, as measured by the secretory units of islet in transplantation (SUIT) index. RESULTS: Patients (N=437) were distributed evenly among SUIT index quartiles 1 to 4 (lowest to highest ß-cell function). Clinical outcomes improved from baseline across all SUIT quartiles; mean changes at week 24 were: glycated hemoglobin (HbA1c; % [mmol/mol]), -0.99 (-10.8), -0.87 (-9.5), -0.86 (-9.4), -0.83 (-9.1); and postprandial plasma glucose (PPG; mmol/L), -7.9, -5.6, -5.5, -4.3 (overall effect P<0.0001). Furthermore, postprandial glucagon was reduced in all SUIT quartiles, while insulinogenic index improved only in patients with higher baseline SUIT (overall effect P=0.0286). No severe symptomatic hypoglycemic events were reported. CONCLUSIONS: Lixisenatide treatment resulted in reductions in HbA1c and PPG levels across all SUIT quartiles. This suggests that non-insulin-related actions of lixisenatide contribute to improved glycemic control in T2D.

Can the atherosclerosis prevention targets be achieved in type 2 diabetes?

Type 2 diabetes mellitus is beside hyperglycemia frequently accompanied by dyslipidemia, arterial hypertension, obesity and other atherosclerosis risks. The article summarizes current status demonstrating that we are far from recommended targets, especially with diabetes, blood pressure and lipid controls. More aggressive drug treatment together with life style changes will be necessary to reach our goals in Type 2 diabetic patients.