Intensive insulin therapy using multiple daily injections (MDI) constitutes the most intense
type of regimen in type 2 diabetes mellitus (T2D). Although highly effective in lowering
blood glucose, it can also increase the risk of hypoglycemia, promote weight gain and cause
significant treatment burden for the patients. As demonstrated by a number of clinical
studies, overtreatment is a common and generally unrecognized problem in patients with T2D;
nevertheless, medication de-escalation is still infrequent in everyday clinical practice.
IGlarLixi is a once-daily fixed-ratio combination (FRC) of a basal insulin and a
glucagon-like peptide-1 receptor agonist (GLP-1 RA), which can offer similar efficacy in
glucose control with lower rates of hypoglycemia and smaller weight gain that basal insulin
regimens. The aim of our randomised, controlled study is to examine prospectively the safety
and efficacy of de-escalating MDI regimens to iGlarLixi in T2D adult patients.