Stronger Treatments and Metabolic Results in People with Type 2 Diabetes Using GLP-1 Therapy

Among 37,198 patients with type 2 diabetes who intensified therapy after glucagon-like peptide 1 receptor agonist failure, different strategies produced varying outcomes.

• The majority of patients intensified therapy with oral antihyperglycemic drugs, especially those with higher body mass index and lower baseline HbA1c.
• Basal insulin was primarily added in patients with higher HbA1c levels (8.9%) and longer diabetes duration.
• Intensification with basal insulin or fixed ratio combinations resulted in the greatest reductions in HbA1c (-0.92% and -0.85%, respectively) without weight gain.
• Oral antihyperglycemic drugs achieved a higher target HbA1c rate (36% with levels below 7%) and maintained weight loss.
• Switching to basal insulin was linked to weight gain (+2.9 kg) and a lower achievement of HbA1c targets (16.8% below 7%).
• There was a noted prevalence of suboptimal insulin titration across all intensification strategies.

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