Comparative Analysis of IDegLira versus Insulin Glargine in Short-Term Intensive Therapy for Overweight or Obese Patients with Type 2 Diabetes Mellitus

Purpose To compare the efficacy of insulin degludec/liraglutide (IDegLira) versus insulin glargine, both combined with insulin aspart, for short-term intensive glycemic control in overweight or obese patients with type 2 diabetes mellitus (T2DM). Method Severely hyperglycemic overweight/obese T2DM patients were randomly assigned to receive either IDegLira plus insulin aspart (observation group) or insulin glargine plus insulin aspart (control group). Continuous glucose monitoring systems (CGMS) were used to assess glycemic control, insulin requirements, pancreaticβ-cell function, and insulin resistance over a seven-day intensive therapy period. Result The observation group exhibited a higher time in range (TIR) compared with the control group ( P  = 0.007). Measures of glycemic variability, including time above range (TAR), mean of daily differences (MODD), mean glucose (MG), standard deviation (SD), and coefficient of variation (CV), were all significantly lower in the IDegLira group ( P  < 0.01). After seven days of treatment, the reduction in C-peptide-based homeostasis model assessment of insulin resistance (HOMA-IR-CP) was greater in the IDegLira group ( P  = 0.001), while the improvement in C-peptide-based homeostasis model assessment of β-cell function (HOMA islet-CPDM) was markedly greater( P  < 0.001). The IDegLira group also required a lower total daily insulin dose at the end of treatment, achieved glycemic targets more rapidly, and demonstrated a higher rate of excellent glycemic control ( P  = 0.001). Conclusion IDegLira combined with insulin aspart provides superior short-term intensive glycemic control compared with insulin glargine plus insulin aspart in overweight or obese patients with T2DM, with faster target achievement, improved glycemic stability, reduced insulin requirements, and greater improvements in insulin resistance and β-cell function.