On Monday, the FDA gave approval to NovoNordisk’s new combination product, Xultophy. This is a combination of the super long-acting insulin degludec and the once daily GLP-1 agonist Liraglutide. The fixed dose combination is given in one to 50 dosing steps to maximize to glycemic control. The super long-acting insulin offers the patient the opportunity for flexible dosing without losing glycemic control.
This new combination is bound to cause some changes in how we look at GLP-1 therapy and how dosing with insulin can have a not always predictable effect on different patients. This week in our Clinical Text, we take a look at the relationship between natural GLP-1, GLP-1 agonists, pancreas-made insulin, and injected insulin. You will be surprised by how much interference in predictability of glucose levels the ratios of these 4 compounds can have.