INTRODUCTION
weight gain, weight loss, hypoglycaemia
ADVERSE EVENTS, HYPERGLYCAEMIA, TYPE 2 DIABETES, HYPOGLYCAEMIA
It is reasonable to start insulin therapy for patients with type 2 diabetes who present with severe hyperglycaemia.Complex insulin regimens have potent blood glucose‐lowering effects, but are associated with hypoglycaemia and weight gain and cause significant treatment burden for the patients. As glucose toxicity resolves, the complex regimens may potentially be simplified, but due to lack of specific guidelines, deintensification is rarely carried out and many patients become overtreated.Patients treated with hypoglycaemic agents who have lower than optimal HbA1c values (usually HbA1c < 6.5% [48 mmol/mol]) are exposed to high hypoglycaemia risk and may be overtreated. Another form of overtreatment may be when the glycaemic status is well controlled, but the patient is using unnecessarily complex insulin regimens instead of simpler alternatives which would ensure the same efficacy with less risk of adverse events.Until recently, only few trials dealt with hypoglycaemic medication simplification and examined the outcomes of different deintensification regimens.IDegLira, a once‐daily, fixed‐ratio combination (FRC) of the long‐acting basal insulin degludec and the glucagon‐like peptide‐1 receptor agonist (GLP‐1RA) liraglutide can be a tool for simplification as it provides similar glycaemic efficacy compared to basal‐bolus therapy in patients who are suboptimally controlled with basal supported oral therapy.We carried out a trial to examine the safety and efficacy of switching from MDI to IDegLira in relatively well controlled (HbA1c ≤ 7.5% [58 mmol/mol]) but potentially overtreated subjects with type 2 diabetes using low total daily insulin dose (TDD). Our preliminary 3‐month follow‐up data showed that in everyday clinical practice insulin treatment simplification with IDegLira was feasible, safe and provided similar or better glycaemic control with less hypoglycaemia and weight loss compared to the previously used complex regimens.The objective of the present paper was to assess the sustained efficacy and safety of the simplified treatment during a 12‐month follow‐up in a larger group of patients.