***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE This study assessed the efficacy and safety of LixiLan , a fixed-ratio , titratable , combination of 2 units insulin glargine ( Gla-100 ) and 1 μg lixisenatide administered once daily via a single pen , versus Gla-100 in insulin-naïve type 2 diabetes on metformin . RESEARCH DESIGN AND METHODS Participants were r and omized to once-daily LixiLan ( n = 161 ) or Gla-100 ( n = 162 ) for 24 weeks , while continuing metformin . LixiLan and Gla-100 were started at 10 units/5 μg and 10 units , respectively , and titrated based on the Gla-100 requirement according to fasting plasma glucose levels . The primary objective was to test noninferiority ( upper bound of the 95 % CI ≤0.4 % ) of LixiLan in reducing HbA1c ; if met , statistical superiority was tested . Secondary objectives included body weight changes , hypoglycemia , and safety . RESULTS Baseline characteristics ( mean age 57 years , diabetes duration 6–7 years , BMI 32 kg/m2 ) were similar between groups . At week 24 , mean HbA1c was reduced from 8.0 % ( 64 mmol/mol ) at baseline to 6.3 % ( 45 mmol/mol ) and 6.5 % ( 48 mmol/mol ) with LixiLan and Gla-100 , respectively , establishing statistical noninferiority and superiority of LixiLan ( least-squared mean [ 95 % CI ] difference : −0.17 % [ −0.31 , −0.04 ] { −1.9 mmol/mol [ −3.4 , −0.4 ] } ; P = 0.01 ) . HbA1c < 7.0 % ( < 53 mmol/mol ) was achieved in 84 % and 78 % of participants ( nonsignificant ) ,  respectively . LixiLan improved 2-h postmeal plasma glucose versus Gla-100 ( least-squared mean difference : –3.17 mmol/L [ –57 mg/dL ] ; P < 0.0001 ) . Body weight was reduced with LixiLan ( –1 kg ) and increased with Gla-100 ( + 0.5 kg ; P < 0.0001 ) , with no increase in hypoglycemic events ( ∼25 % in each group ) . The incidence of nausea ( 7.5 % ) and vomiting ( 2.5 % ) was low with LixiLan . CONCLUSIONS LixiLan achieved statistically significant reductions to near-normal HbA1c levels with weight loss and no increased hypoglycemic risk , compared with insulin glargine alone , and a low incidence of gastrointestinal adverse events in type 2 diabetes inadequately controlled on metformin OBJECTIVE To compare ultra-long-acting insulin degludec with glargine for efficacy and safety in insulin-naive patients with type 2 diabetes inadequately controlled with oral antidiabetic drugs ( OADs ) . RESEARCH DESIGN AND METHODS In this 1-year , parallel-group , r and omized , open-label , treat-to-target trial , adults with type 2 diabetes with A1C of 7−10 % taking OADs were r and omized 3:1 to receive once daily degludec or glargine , both with metformin . Insulin was titrated to achieve prebreakfast plasma glucose ( PG ) of 3.9−4.9 mmol/L. The primary end point was confirmation of noninferiority of degludec to glargine in A1C reduction after 52 weeks in an intent-to-treat analysis . RESULTS In all , 1,030 participants ( mean age 59 years ; baseline A1C 8.2 % ) were r and omized (  degludec 773 , glargine 257 ) . Reduction in A1C  with degludec was similar ( noninferior ) to that with glargine ( 1.06 vs. 1.19 % ) , with an estimated treatment difference of degludec to glargine of 0.09 % ( 95 % CI −0.04 to 0.22 ) . Overall rates of confirmed hypoglycemia ( PG < 3.1 mmol/L or severe episodes requiring assistance ) were similar , with degludec and glargine at 1.52 versus 1.85 episodes/patient-year of exposure ( PYE ) . There were few episodes of nocturnal confirmed hypoglycemia in the overall population , and these occurred at a lower rate with degludec versus glargine ( 0.25 vs. 0.39 episodes/PYE ; P = 0.038 ) . Similar percentages of patients in both groups achieved A1C levels < 7 % without hypoglycemia . End-of-trial mean daily insulin doses were 0.59 and 0.60 units/kg for degludec and glargine , respectively . Adverse event rates were similar . CONCLUSIONS Insulins degludec and glargine administered once daily in combination with OADs provided similar long-term glycemic control in insulin-naive patients with type 2 diabetes , with lower rates of nocturnal hypoglycemia with degludec AIMS To compare the efficacy and safety of once-daily pr and ial lixisenatide with placebo in type 2 diabetes mellitus ( T2DM ) insufficiently controlled by pioglitazone ± metformin . METHODS This r and omized , double-blind study included a 24-week main treatment period and a ≥52-week variable extension period . Patients were r and omized 2 : 1 to receive lixisenatide 20 µg once daily or placebo . The primary endpoint was change in glycated haemoglobin ( HbA1c ) at week 24 . RESULTS In total , 484 patients were r and omized : 323 to lixisenatide ; 161 to placebo . After 24 weeks , lixisenatide once daily significantly improved HbA1c ( -0.56 % vs. placebo ; p < 0.0001 ) and increased the proportion of patients achieving HbA1c < 7 % compared with placebo ( 52.3 % vs. 26.4 % , respectively ; p < 0.0001 ) and significantly improved fasting plasma glucose ( -0.84 mmol/l vs. placebo ; p < 0.0001 ) . There was a small decrease in body weight  with lixisenatide once daily and a small increase with placebo , with no statistically significant difference between the two groups . Overall , lixisenatide once daily was well tolerated , with a similar proportion of treatment-emergent adverse events ( TEAEs ) and serious TEAEs between groups ( lixisenatide : 72.4 % and 2.5 % ; placebo : 72.7 % and 1.9 % ) . Symptomatic hypoglycaemia rates were also relatively low in both groups ( lixisenatide 3.4 % and placebo 1.2 % ) , with no severe episodes . Lixisenatide continued to be efficacious and well tolerated during the variable extension period . CONCLUSIONS Lixisenatide once daily significantly improved glycaemic control with a low risk of hypoglycaemia , and was well tolerated over 24 weeks and during the long-term , double-blind extension period in patients with T2DM insufficiently controlled on pioglitazone ± metformin Aim To investigate the safety and efficacy of insulin degludec/liraglutide ( IDegLira ) , a novel combination product , as add‐on therapy for people with Type 2 diabetes uncontrolled on sulphonylurea therapy . Methods In this 26‐week , double‐blind trial , adults with Type 2 diabetes [ HbA1c 53–75 mmol/mol ( 7.0–9.0 % ) ] were r and omized to IDegLira ( n = 289 ) or placebo ( n = 146 ) as add‐on to pre‐trial sulphonylurea ± metformin , titrating to a fasting glycaemic target of 4.0–6.0 mmol/l . Treatment initiation was at 10 dose steps , and maximum dose was 50 dose steps ( 50 units insulin degludec/1.8 mg liraglutide ) . Results The mean HbA1c decreased from 63 mmol/mol ( 7.9 % ) to 46 mmol/mol ( 6.4 % ) with IDegLira and to 57 mmol/mol ( 7.4 % ) with placebo [ estimated treatment difference –11 mmol/mol ( 95 % CI –13 ; –10 ) or –1.02 % ( 95 % CI –1.18 ; –0.87 ) ; P < 0.001 ] . The HbA1c target of 53 mmol/mol ( < 7 % ) was achieved by 79.2 % of participants in the IDegLira group vs 28.8 % in the placebo group [ estimated odds ratio 11.95 ( 95 % CI 7.22 ; 19.77 ) ; P < 0.001 ] . Mean weight change was + 0.5 kg with IDegLira vs –1.0 kg with placebo [ estimated treatment difference 1.48 kg ( 95 % CI 0.90 ; 2.06 ) ; P < 0.001 ] . Confirmed hypoglycaemia occurred in 41.7 and 17.1 % of IDegLira‐ and placebo‐treated participants , respectively , with rates of 3.5 vs 1.4 events/patient‐years of exposure [ estimated rate ratio 3.74 ( 95 % CI 2.28 ; 6.13 ) ; P < 0.001 ] . IDegLira was generally well tolerated . The rates of serious adverse events were 20.3 and 8.0 per 100 patient‐years of exposure with IDegLira and placebo , respectively , without obvious patterns in the type of events . Conclusions IDegLira can be used in people uncontrolled with sulphonylurea ± metformin to improve efficacy with a safety profile in line with previous DUAL trials . What 's new?IDegLira is a combination of insulin degludec and liraglutide . Basal insulins and glucagon‐like peptide‐1 ( GLP‐1 ) receptor agonists have complementary effects in a Type 2 diabetes treatment regimen , with GLP‐1 receptor agonists also being insulin‐sparing . Treatment guidelines often advocate discontinuing sulphonylureas on basal insulin initiation , but widespread concomitant use of these drugs continues in current clinical practice . It is therefore anticipated that many  sulphonylurea‐treated people will have IDegLira added to their therapy , yet this combination has not previously been studiedThis r and omized controlled trial shows that IDegLira can be used in people uncontrolled  with sulphonylureas ± metformin  to improve efficacy with a favourable benefit – risk profile Aim Assess the pharmacodynamics of lixisenatide once daily ( QD ) versus liraglutide QD in type 2 diabetes insufficiently controlled on metformin . Methods In this 28-day , r and omized , open-label , parallel-group , multicentre study ( NCT01175473 ) , patients ( mean HbA1c 7.3 % ) received subcutaneous lixisenatide QD  ( 10 µg weeks 1–2 , then 20 µg ; n = 77 ) or liraglutide QD ( 0.6 mg week 1 , 1.2 mg week 2 , then 1.8 mg ; n = 71 ) 30 min before breakfast . Primary endpoint was change in postpr and ial plasma glucose ( PPG ) exposure from baseline to day 28 during a breakfast test meal . Results Lixisenatide  reduced PPG significantly more than liraglutide [ mean change in AUC0:30–4:30h : −12.6 vs. −4.0 h·mmol/L , respectively ; p < 0.0001 ( 0:30 h = start of meal ) ] . Change in maximum PPG excursion was −3.9 mmol/l vs. −1.4 mmol/l , respectively ( p < 0.0001 ) . More lixisenatide-treated patients achieved 2-h PPG < 7.8 mmol/l ( 69 % vs. 29 % ) . Changes in fasting plasma glucose were greater with liraglutide ( −0.3 vs. −1.3 mmol/l , p < 0.0001  ) . Lixisenatide provided greater decreases in postpr and ial glucagon ( p < 0.05 ) , insulin ( p < 0.0001 ) and C-peptide ( p < 0.0001 ) . Mean HbA1c decreased in both treatment groups ( from 7.2 % to 6.9 % with lixisenatide vs. 7.4 % to 6.9 % with liraglutide ) as did body weight ( −1.6 kg vs. −2.4 kg , respectively ) . Overall 
    Output:
    
Glucose control of IGlarLixi treatment or IDegLira treatment was significantly lower than that at baseline .
Comparisons between the two treatment groups indicated no significant differences between groups in absolute HbA1c changes or body weight changes relative to baseline