Efficacy and safety of switching to iGlarLixi from premixed insulin therapy in patients with type 2 diabetes: A real‐world experience

AIMS: Fixed-ratio combinations such as iGlarLixi are recommended over premixed insulin as first-line injectable therapy for type 2 diabetes mellitus (T2DM), yet real-world evidence on transitions from premix to iGlarLixi remains limited. This study aimed to evaluate the efficacy and safety of switching from premixed insulin to iGlarLixi in a real-world clinical setting. METHODS: This retrospective cohort included adults with T2DM who transitioned from premixed insulin to iGlarLixi between July 2020 and July 2023 at Taipei Veterans General Hospital. Glycaemic parameters were collected at baseline, 3 and 6 months after transition. RESULTS: reduction was observed in those previously on 40-50 units/day of premix insulin (from 83 ± 21 [9.8% ± 1.9%] to 65 ± 15 mmol/mol [8.1% ± 1.4%], p = 0.037). Total insulin dose and injection frequency significantly decreased (p < 0.001), while hypoglycaemia incidence dropped from 60.0% to 12.5% (p < 0.001). Among patients with pre-existing hypoglycaemia, glycaemic control remained stable despite reductions in insulin dose and injection frequency (p = 0.001, p = 0.032, respectively). Higher HOMA-IR was significantly associated with suboptimal glycaemic response in multivariate model (p = 0.037). CONCLUSIONS: Switching from premixed insulin to iGlarLixi is a safe and effective strategy to simplify therapy and improve glycaemic management. Insulin resistance may influence response.