CGM-derived postprandial glucose with IcoSema versus other insulin regimens: a post hoc analysis of COMBINE 1 and 3
Abstract
Background: Impaired insulin and incretin responses, alongside elevated postprandial glucose (PPG) levels after meals, are hallmarks of type 2 diabetes (T2D) and can lead to postprandial hyperglycaemia. This post hoc analysis used PPG levels derived from continuous glucose monitoring (CGM) to investigate the effect of IcoSema versus other insulin-based regimens on PPG control in T2D.
Methods: In this post hoc analysis, a modified Glucose Rate Increase Detector (GRID) algorithm was used to assess the effect of IcoSema compared with once-weekly basal insulin icodec (icodec) or daily basal-bolus therapy (BBT) on PPG endpoints in adults with inadequately controlled T2D, using data from the COMBINE 1 and 3 trials. In the randomised, phase 3a COMBINE 1 and 3 trials, IcoSema (a once-weekly combination therapy of basal insulin icodec [icodec] and semaglutide) was investigated versus icodec (COMBINE 1) or daily BBT (insulin glargine U100 + insulin aspart; COMBINE 3). CGM data collected during weeks 48-52 were used to estimate mealtimes using the GRID algorithm and to derive PPG endpoints. The primary aim of this analysis was to use CGM data collected during the final 4 weeks of treatment in COMBINE 1 and 3 to determine the effect of IcoSema versus other insulin-based regimens on PPG control in individuals with T2D. Data were analysed using the full analysis set (all randomly assigned participants) and the on-treatment period. Participants were screened between June 1, 2022-March 13,…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 1,650 participants or records.
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