Moderate
Established
Mô tả
Liraglutide combined with insulin glargine enhances glycaemic control but increases hypoglycaemia risk; the combination (IDegLira fixed-ratio product concept) requires insulin dose reduction.
Cơ chế
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.
Ý nghĩa lâm sàng
LEADER trial and combination therapy studies confirm clinically relevant hypoglycaemia rate increase; a 20% insulin dose reduction at liraglutide initiation is standard practice.
Xử trí
Reduce insulin glargine dose by ~20% when starting liraglutide; titrate based on fasting glucose; increase SMBG frequency during dose adjustment phase.