Moderate
Established
Description
Combining semaglutide with insulin glargine increases hypoglycaemia risk; however, the combination is used clinically with appropriate dose adjustments for improved glycaemic control.
Mécanisme
Semaglutide enhances glucose-dependent insulin secretion and suppresses glucagon, adding to the glucose-lowering effect of exogenous insulin glargine. The risk is pharmacodynamic and glucose-dependent.
Signification clinique
SUSTAIN clinical trials reported higher rates of hypoglycaemia when semaglutide was added to basal insulin; the combination requires insulin dose reduction of approximately 20% at initiation.
Prise en charge
Reduce insulin glargine dose by 20% when initiating semaglutide; intensify blood glucose self-monitoring; titrate both agents individually based on fasting glucose targets.