Moderate
Established
Deskripsi
Liraglutide combined with insulin glargine enhances glycaemic control but increases hypoglycaemia risk; the combination (IDegLira fixed-ratio product concept) requires insulin dose reduction.
Mekanisme
Liraglutide's glucose-dependent insulinotropic and glucagon-suppressive actions add pharmacodynamically to the basal insulin effect of glargine, increasing the likelihood of blood glucose falling below normal levels.
Signifikansi Klinis
LEADER trial and combination therapy studies confirm clinically relevant hypoglycaemia rate increase; a 20% insulin dose reduction at liraglutide initiation is standard practice.
Penatalaksanaan
Reduce insulin glargine dose by ~20% when starting liraglutide; titrate based on fasting glucose; increase SMBG frequency during dose adjustment phase.