***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: AIMS To evaluate the impact of β-cell function on the efficacy of lixisenatide , a once-daily pr and ial glucagon-like peptide-1 receptor agonist , in patients with type 2 diabetes ( T2D ) . MATERIAL S AND METHODS In this post hoc analysis , patients from the Phase 3 Get Goal -M and Get Goal -S clinical trials r and omized to lixisenatide 20μg once daily were stratified into quartiles by baseline β-cell function , as measured by the secretory units of islet in transplantation ( SUIT ) index . RESULTS Patients ( N=437 ) were distributed evenly among SUIT index quartiles 1 to 4 ( lowest to highest β-cell function ) . Clinical outcomes improved from baseline across all SUIT quartiles ; mean changes at week 24 were : glycated hemoglobin ( HbA1c ; % [ mmol/mol ] ) , -0.99 ( -10.8 ) , -0.87 ( -9.5 ) , -0.86 ( -9.4 ) , -0.83 ( -9.1 ) ; and postpr and ial plasma glucose ( PPG ; mmol/L ) , -7.9 , -5.6 , -5.5 , -4.3 ( overall effect P<0.0001 ) . Furthermore , postpr and ial glucagon was reduced in all SUIT quartiles , while insulinogenic index improved only in patients with higher baseline SUIT ( overall effect P=0.0286 ) . No severe symptomatic hypoglycemic events were reported . CONCLUSIONS Lixisenatide treatment result ed in reductions in HbA1c and PPG levels across all SUIT quartiles . This suggests that non-insulin-related actions of lixisenatide contribute to improved glycemic control in T2D 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 OBJECTIVE To examine the efficacy and safety of lixisenatide ( 20 μg once daily , administered before the morning or evening meal ) as add-on therapy in patients with type 2 diabetes insufficiently controlled with metformin alone . RESEARCH DESIGN AND METHODS This was a 24-week , r and omized , double-blind , placebo-controlled study in 680 patients with inadequately controlled type 2 diabetes ( HbA1c 7–10 % [ 53−86 mmol/mol ] ) . Patients were r and omized to lixisenatide morning ( n = 255 ) , lixisenatide evening ( n = 255 ) , placebo morning ( n = 85 ) , or placebo evening ( n = 85 ) injections . RESULTS Lixisenatide morning injection significantly reduced mean HbA1c versus combined placebo ( mean change −0.9 % [ 9.8 mmol/mol ] vs. −0.4 % [ 4.4 mmol/mol ] ; least squares [ LS ] mean difference vs. placebo −0.5 % [ 5.5 mmol/mol ] , P < 0.0001 ) . HbA1c was significantly reduced by lixisenatide evening injection ( mean change –0.8 % [ 8.7 mmol/mol ] vs. –0.4 % [ 4.4 mmol/mol ] ; LS mean difference –0.4 % [ 4.4 mmol/mol ] , P < 0.0001 ) . Lixisenatide morning injection significantly reduced 2-h postpr and ial glucose versus morning placebo ( mean change −5.9 vs. −1.4 mmol/L ; LS mean difference −4.5 mmol/L , P < 0.0001 ) . LS mean difference in fasting plasma glucose was significant in both morning ( –0.9 mmol/L , P < 0.0001 ) and evening ( –0.6 mmol/L , P = 0.0046 ) groups versus placebo . Mean body weight decreased to a similar extent in all groups . Rates of adverse events were 69.4 % in both lixisenatide groups and 60.0 % in the  placebo group . Rates for nausea and vomiting were 22.7 and 9.4 % for lixisenatide morning and 21.2 and 13.3 % for lixisenatide evening versus 7.6 and 2.9 % for placebo , respectively . Symptomatic hypoglycemia occurred in 6 , 13 , and 1 patient for lixisenatide morning , evening , and placebo , respectively , with no severe episodes . CONCLUSIONS In patients with type 2 diabetes inadequately controlled on metformin  , lixisenatide 20 μg once daily administered in the morning or evening significantly improved glycemic control , with a pronounced postpr and ial effect , and was well tolerated 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 incidence of adverse events was lower with lixisenatide ( 55 % ) versus liraglutide ( 65 % ) , with no serious events or hypoglycaemia reported . Conclusions Once daily prebreakfast lixisenatide provided a significantly greater reduction in PPG ( AUC ) during a morning test meal versus prebreakfast liraglutide . Lixisenatide provided significant decreases in postpr and ial insulin , C-peptide ( vs. an increase with liraglutide ) and glucagon , and better gastrointestinal tolerability than liraglutide OBJECTIVE When oral therapy for type 2 diabetes is ineffective , adding basal insulin improves glycemic control . However , when glycated hemoglobin ( HbA1c ) remains elevated because of postpr and ial hyperglycemia , the next therapeutic step is controversial . We examined the efficacy and safety of  lixisenatide  in patients with HbA1c still elevated after initiation of insulin glargine . RESEARCH DESIGN AND METHODS This double-blind , parallel-group trial enrolled patients with HbA1c 7–10 % despite oral therapy .  Insulin glargine was added and systematic ally titrated during a 12-week run-in , after which c and i date s with fasting glucose ≤7.8 mmol/L and HbA1c 7–9 % were r and omized  to lixisenatide 20 µg or placebo for 24 weeks while insulin titration continued . The primary end point was HbA1c change after r and omization . RESULTS The r and omized population ( n = 446 ) had mean diabetes duration of 9.2 years , BMI 31.8 kg/m2 , and daily glargine dosage of 44 units . HbA1c had decreased during run-in from 8.6 to 7.6 % ; adding lixisenatide further reduced HbA1c by 0.71 vs. 0.40 % with placebo ( least squares mean difference , –0.32 % ; 95 % CI , –0.46 to –0.17 ; P < 0.0001 ) . More participants  attained HbA1c < 7  % with lixisenatide ( 56 vs. 39 % ; P < 0.0001 ) . Lixisenatide  reduced plasma glucose 2 h after a st and ardized breakfast ( difference vs. placebo –3.2 mmol/L ; P < 0.0001 ) and had a favorable effect on body weight ( difference vs. placebo –0.89 kg ; P = 0.0012 ) . Nausea , vomiting , and symptomatic hypoglycemia < 3.3 mmol/L were more common with lixisenatide . CONCLUSIONS Adding lixisenatide to insulin glargine improved overall and postpr and ial hyperglycemia and deserves consideration as an alternative to pr and ial insulin for patients not reaching HbA1c goals with recently initiated basal insulin Aims To assess the efficacy and safety of once-daily lixisenatide versus placebo in Asian patients with type 2 diabetes insufficiently controlled on basal insulin ± sulfonylurea . Methods In this 24-week , r and omized , double-blind , placebo-controlled , parallel-group , multicentre study , participants ( mean baseline HbA1c 8.53 % ) from Japan , Republic of Korea , Taiwan and the Philippines received lixisenatide ( n = 154 ) or placebo ( n = 157 ) in a stepwise dose increase to 20 µg once daily . The primary endpoint was HbA1c change from baseline to week 24 . Results Once-daily lixisenatide significantly improved HbA1c versus placebo ( LS mean difference vs. placebo = −0.88 % [ 95%CI= −1.116 , −0.650 ] ; p < 0.0001 ) , and allowed more patients to achieve HbA1c < 7.0 % ( 35.6 vs. 5.2 % ) and ≤6.5 % ( 17.8 vs. 1.3 % ) . Lixisenatide also significantly improved 2-h postpr and ial plasma glucose and glucose excursion , average 7-point self-monitored blood glucose and fasting plasma glucose . Lix 
    Output:
    
Lixisenatide was well tolerated , demonstrating rates of symptomatic hypoglycemia of 0.8 - 42.9 % and a very low rate of severe hypoglycemia ( < 1.5 % ) as well as no increased risk of cardiovascular events .
The most common adverse events were gastrointestinal in nature , mainly transient nausea and vomiting of mild-to-moderate severity .
Lixisenatide effectively lowers HbA1c levels in patients with T2D through a mechanism of action complementary to that of agents that mainly target FPG , with the additional benefit of weight loss .