IGlarLixiIn Type 2 Diabetes Mellitus (T2DM) the body's insulin is not as effective in reducing blood glucose, and so a greater amount of insulin is required to lower blood glucose when compared to a person without T2DM. This is termed as insulin resistance, a challenge difficult to overcome and may eventually lead to insulin deficiency. Excess weight is the most common reason that drives insulin resistance in most patients with T2DM. Greater amount of insulin may cause further increase in weight and therefore it becomes a vicious cycle presenting a dilemma to the treating doctor.Weight loss medicines exist in an injection form, just like insulin, and have become successful in helping patients reduce up to a quarter of their body weights thereby improving T2DM status. Moreover, they have been proven to protect the heart and kidneys independent of the effect of normalising glucose levels. Among this group, medicines that promote the effect of the hormone glucagon-like-peptide-1 (GLP-1), called GLP-1 agonists (GLP-1a), are the first and most commonly prescribed option and Lixisenatide was one of the first to come to the market.Combining insulin and GLP-1a would seem like a marriage made in heaven as both achieve the common goal of reducing blood glucose levels, with the added advantages conferred on weight, and vital organs like the heart and kidneys. iGlarLixi is a combination of the insulin Lantus, a basal insulin, and Lixisenatide, a once-daily GLP-1a.Mechanism of actionLantus being a basal insulin helps control fasting glucose and Lixisenatide by releasing body's insulin in response to rise of glucose after a meal helps control postprandial glucoseRx. Single injection, taken at the same time once every day, usually an hour before a meal. Injection to be taken subcutaneously, i.e., in the fat below the skin, in exactly the same way as any insulin. An injection dose of 3 delivers 3 units of Lantus for every 1mcg of Lixisenatide. Dose should only be increased on a weekly basisAdvantages. Protects from weight gain which may be seen with insulin therapy alone, and may also result in some weight loss. Two medicines delivered together in a single shot. Single injection on a daily basisSide effects. The most common side effect is nausea which improves with time. It contains insulin and so may still cause hypoglycemia which needs monitoringWord of caution. It is not to be used in patients with advanced renal disease. In patients with liver disease, dose adjustment would require added attention. It should not be used in pregnant patients Dr Ragini Bhake is a Consulting Diabetologist and Endocrinologist
IGlarLixiIn Type 2 Diabetes Mellitus (T2DM) the body's insulin is not as effective in reducing blood glucose, and so a greater amount of insulin is required to lower blood glucose when compared to a person without T2DM. This is termed as insulin resistance, a challenge difficult to overcome and may eventually lead to insulin deficiency. Excess weight is the most common reason that drives insulin resistance in most patients with T2DM. Greater amount of insulin may cause further increase in weight and therefore it becomes a vicious cycle presenting a dilemma to the treating doctor.Weight loss medicines exist in an injection form, just like insulin, and have become successful in helping patients reduce up to a quarter of their body weights thereby improving T2DM status. Moreover, they have been proven to protect the heart and kidneys independent of the effect of normalising glucose levels. Among this group, medicines that promote the effect of the hormone glucagon-like-peptide-1 (GLP-1), called GLP-1 agonists (GLP-1a), are the first and most commonly prescribed option and Lixisenatide was one of the first to come to the market.Combining insulin and GLP-1a would seem like a marriage made in heaven as both achieve the common goal of reducing blood glucose levels, with the added advantages conferred on weight, and vital organs like the heart and kidneys. iGlarLixi is a combination of the insulin Lantus, a basal insulin, and Lixisenatide, a once-daily GLP-1a.Mechanism of actionLantus being a basal insulin helps control fasting glucose and Lixisenatide by releasing body's insulin in response to rise of glucose after a meal helps control postprandial glucoseRx. Single injection, taken at the same time once every day, usually an hour before a meal. Injection to be taken subcutaneously, i.e., in the fat below the skin, in exactly the same way as any insulin. An injection dose of 3 delivers 3 units of Lantus for every 1mcg of Lixisenatide. Dose should only be increased on a weekly basisAdvantages. Protects from weight gain which may be seen with insulin therapy alone, and may also result in some weight loss. Two medicines delivered together in a single shot. Single injection on a daily basisSide effects. The most common side effect is nausea which improves with time. It contains insulin and so may still cause hypoglycemia which needs monitoringWord of caution. It is not to be used in patients with advanced renal disease. In patients with liver disease, dose adjustment would require added attention. It should not be used in pregnant patients Dr Ragini Bhake is a Consulting Diabetologist and Endocrinologist
