Diabetes Trial Files: A Metabolic Intervention Regimen vs. Standard Care for T2DM Remission, Inhaled TI + Insulin Degludec in T1DM, and Cotadutide in T2DM & CKD
Evaluating remission of type 2 diabetes using a metabolic intervention including fixed-ratio insulin degludec and liraglutide
Punthakee Z et al. Diabetes, Obesity and Metabolism (September 2024)
Bottom Line: This was a multicentre open-label randomized controlled trial in insulin-naïve participants within 5 years of diabetes diagnosis. The study compared a 16-week remission intervention regimen, including frequent dietary, exercise and diabetes management coaching, metformin, and fixed-ratio insulin degludec/liraglutide, to standard care. A total of 159 participants were randomized and analyzed. The primary outcome was diabetes relapse within 1 year, and the intervention group had a lower hazard of relapse compared to the control group. However, sustained remission was not achieved. The study concluded that the intensive intervention reduced the risk of relapse, but did not lead to sustained remission.
A Randomized Trial Comparing Inhaled Insulin Plus Basal Insulin Versus Usual Care in Adults With Type 1 Diabetes
Hirsch IB et al. American Diabetes Association (December 2024)
Bottom Line: This 17-week clinical trial evaluated the efficacy and safety of inhaled Technosphere insulin (TI) plus insulin degludec in adults with type 1 diabetes. The study included 123 participants who were randomly assigned to either the intervention group (TI plus insulin degludec) or the comparator group (usual care). The primary outcome was HbA1c after 17 weeks, with the intervention group showing a noninferiority to the control group. The most common side effect for the intervention group was a brief cough, with eight participants discontinuing the treatment due to side effects. Overall, the results suggest that TI may be a viable option for adults with type 1 diabetes, particularly for those looking to reduce postprandial hyperglycemia.
A randomized phase 2b trial examined the effects of the glucagon-like peptide-1 and glucagon receptor agonist cotadutide on kidney outcomes in patients with diabetic kidney disease
Selvarajah V et al. Kidney International (December 2024)
Bottom Line: This phase 2b study evaluated the potential of cotadutide, a GLP-1 and glucagon receptor agonist, to improve kidney function in patients with T2D and CKD. 248 patients were randomized to receive either cotadutide at 100, 300, or 600 μg daily, placebo, or the GLP-1 agonist semaglutide 1 mg once weekly. The co-primary endpoints were the reduction in UACR from baseline to week 14. Results showed a dose-dependent reduction in UACR with cotadutide, reaching significance at 300 μg and 600 μg compared to placebo. Safety and tolerability were comparable to semaglutide. This study suggests that cotadutide may have kidney protective benefits in this patient population, but further confirmation is needed.
Diabetes Trial Files Issue #DIA-2025-01
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