Residual hyperglycemia (glycated hemoglobin [HbA1c] over target despite fasting plasma glucose [FPG] at target) presents an obstacle in achieving glycemic control in T2D. GLP-1 receptor agonist (RA) therapy can target excessive postprandial glycemia (PPG) and thereby address residual hyperglycemia. This analysis investigated the effect of iGlarLixi, a fixed-ratio combination of insulin glargine (iGlar) U100 and the GLP-1 RA lixisenatide (Lixi), on the proportion of patients with T2D with discordant HbA1c/FPG (HbA1c ≥7% and FPG <140 mg/dL) in the LixiLan-L trial. Patients who had suboptimal glycemic control despite basal insulin ± oral antidiabetes drugs (OADs) stopped all OADs but metformin and, after 6 weeks of iGlar run-in, were randomized to iGlarLixi or iGlar for 30 weeks (N=736). At baseline (post-run-in), proportions with discordant HbA1c/FPG were similar in the two arms. After 12-week randomized treatment, proportions with discordant HbA1c/FPG were 32.1% (iGlarLixi) and 49.9% (iGlar; p<0.0001; Figure). After 30 weeks, the prevalence of discordant HbA1c/FPG was further reduced with iGlarLixi vs. iGlar (22.7% vs. 45.9%; p<0.0001).

In conclusion, iGlarLixi reduces the proportion of T2D patients with discordant HbA1c/FPG levels more than iGlar does, reflecting its capacity to address residual hyperglycemia by targeting both FPG and PPG.


F. Giorgino: Consultant; Self; Abbott, AstraZeneca, Boehringer Ingelheim GmbH. Research Support; Self; Eli Lilly and Company, Johnson & Johnson Services, Inc.. Consultant; Self; MedImmune, Merck Sharp & Dohme Corp., Roche Diabetes Care Health and Digital Solutions, Sanofi. Research Support; Self; Takeda Development Centre Europe Ltd. R. Retnakaran: Research Support; Self; Novo Nordisk Inc.. Consultant; Self; Novo Nordisk Inc.. Research Support; Self; Boehringer Ingelheim Pharmaceuticals, Inc.. Consultant; Self; Sanofi, Eli Lilly and Company. J. Vidal: None. V. Aroda: Consultant; Self; Novo Nordisk Inc.. Research Support; Self; Novo Nordisk Inc., AstraZeneca, Calibra Medical, Eisai Inc., Sanofi. Consultant; Self; Sanofi. Research Support; Self; Theracos, Inc.. Employee; Spouse/Partner; Merck & Co., Inc.. Other Relationship; Self; American Diabetes Association. Consultant; Self; ADOCIA. A. Saremi: Employee; Self; Sanofi US. M. Liu: Employee; Self; Sanofi.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at