Background: Rx with SU and Metformin lowered daily dose of insulin glargine with desirable glycemia. However, Soliqua trials excluded SU and subjects with morbid obesity. Objective: Assess long term efficacy and safety of Soilqua with Glimepiride and Metformin in subjects with type 2 diabetes. Subjects: 31 adults with type 2 diabetes wre identified as currently using Soliqua via EMR. One is excluded as therapy < 3 months. A1c >7.5% with 1) Glimepiride, Metformin and Basal insulin , 2) Metformin and/or DPP 4 inhibitors and/or other SUs and /or GLP1 RA and/or Basal and/or prandial insulin. Subjects with gastroparesis, Triglycerides > 300 mg/dl and pancreatitis are excluded.

Methods: Oral drugs besides Glimepiride and Metformin, Basal and prandial insulin and GLP1 RA were stopped. Glimepiride 8 mg, Metformin 1000-2000 mg were started with Soliqua daily dose pre-breakfast based on previous basal insulin dose and increased by 2 units every 3 days until AM sugar >80<130 mg/dl was attained or dose of 60 units was reached. Comparisons are conducted forBW (kg), fasting glucose (mg/dl) and A1c (%) prior to initiation of therapy and at the time of analysis.

Results: BMI ranged between 22-67. Duration of diabetes is 4-24 years. Duration of therapy range, 5-47 (mean 16± 6 )months. Fasting glucose declined from 167±15 to 118± 4 and A1c dropped from 9.7±0.8 to 7.6±0.3. No severe hypoglycemia was reported. In 4 morbidly obese subjects, fasting glucose and A1c declined though not achieving desirable goals despite receiving maximal dose, 60 units. Mean daily dose of Soliqua was lower (0.38±0.08 units /kg BW compared to pivotal trials (0.44 units /kg BW).

Conclusion: Soliqua is cost effective and safe in the long term in all subjects irrespective of BMI, when administered in combination with glimepiride and metformin. Moreover, it may be useful when administered with Glimepiride and Metformin in more subjects with higher BMI without attaining maximum daily dose in comparison to pivotal trials.

Disclosure

U. M. Kabadi: None. S. Exley: None.

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