“A simplified Therapeutic Approach in Patients with Type 2 Diabetes Mellitus Through the Use of the Fixed-Ratio Combination of Insulin Glargine Plus lixisenatide (iglarlixi): An Account of Our Experience in Frail Elderly Patients”

Background and Aims Approximately 50% of patients with type 2 diabetes mellitus do not reach glycemic targets and need treatment intensification or simplification. The aim of the study was to reduce the use of basal bolus approach among frail elderly patients to avoid hypoglycemia or to intensify treatment in case of hyperglycemia. The application of fixed-ratio combination of insulin glargine/ lixisenatide (iGlarLixi) promotes the mechanism of action of both drugs on hyperglycaemia while minimizing adverse effects. Materials/Patients and Methods We enrolled 70 patients (aged>65) from July to December 2023 referred to our outpatients visit or admitted to Endocrine Diseases department. 60% of patients presented basal bolus therapy and with at least 3 episodes of recent hypoglycaemia, while 40% of patients severe hyperglycaemia, requiring therapy intensification. Results 45% of patients treated with iGlarLixi achieved an improvement in glycated hemoglobin already in the first 3 months of therapy with an average reduction of approximately 1 unit. Additionally, 30% of patients who transitioned from basal bolus therapy to iGlarLixi achieved an average weight loss of 4 kg. Discussion In our experience in frail elderly patients the use of iGlarLixi has revealed improvement in both fasting and postprandial blood glucose, reducing the risk of fasting hypoglycaemia. Moreover, it proved to be an effective treatment for enhancing glycated haemoglobin levels and reducing body weight.