{"id":"6204d6b06cdf","type":"article","url":"https://hartvaat.nl/2026/09/04/vast-dosiskombinatie-van-basaal-insuline-en-glp-1-ra-biedt-voordeel-bij-complexe/","title":"Vast-dosiskombinatie van basaal insuline en GLP-1-RA biedt voordeel bij complexe type 2-diabetes — iGlarLixi","title_en":"Use of fixed-ratio combination of basal insulin and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in Asians with type 2 diabetes.","category":"chronische nierziekte","category_label":"Nierziekte","professions":["huisarts","internist"],"tags":[],"journal":"Primary care diabetes","doi":"10.1016/j.pcd.2026.08.005","source_url":"https://doi.org/10.1016/j.pcd.2026.08.005","authors":["Alice Pik-Shan Kong","Chun-Kwan O","Siran Lai","Chih-Yuan Wang","Juliana Chung-Ngor Chan"],"significance":5,"published":"2026-09-12","source_date":"2026-09-04","image":"","kennis":["https://hartvaat.nl/kennis/cardiometabool/cardiometabool-spreekuur/","https://hartvaat.nl/kennis/cardiometabool/diabetes-en-cardiovasculair-risico/"],"congress":"","summary_en":"This narrative review examines the fixed-ratio combination of basal insulin and a GLP-1 receptor agonist (iGlarLixi) in Asian patients with type 2 diabetes. It highlights the distinct Asian phenotype and argues that dual therapy improves adherence, glycaemic control, and offers potential cardiorenal protection compared to monotherapy. While the evidence is predominantly derived from Asian cohorts, the review provides practical guideline insights and case examples for managing complex diabetes cases where insulin and GLP-1 RA co-therapy is indicated.","created":"2026-09-06T01:00:27Z","updated":"2026-09-06T01:00:27Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Deze narratieve review bespreekt de vast-dosiskombinatie iGlarLixi (basaal insuline plus GLP-1-RA) bij Aziatische patiënten met type 2-diabetes. Het artikel benadrukt het specifieke Aziatische fenotype en stelt dat de combinatie therapietrouw en glycemische regeling verbetert, met potentiële cardiorenale voordelen. Voor de Nederlandse praktijk biedt het een overzicht van richtlijnadviezen en casuïstiek bij complexe diabeteszorg, hoewel de onderliggende data voornamelijk uit Aziatische populaties stammen.","abstract_original":"People with type 2 diabetes in Asia have heterogeneous phenotypes but share common features of young age-at-diagnosis, low body mass index, low pancreatic beta-cell capacity, rapid decline in insulin secretion as well as visceral and ectopic fat excess. Cardiovascular diseases are the leading causes of mortality in people with diabetes. In clinical trial settings, despite receiving protocol-driven care, Asians had higher risk of chronic kidney disease than non-Asians. Aging and improved survival in people with diabetes continue to drive the epidemic of diabetes. People with old age, long disease duration and complications might benefit from both insulin to optimize glucose control and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) for cardiovascular-renal protection. Complex therapies pose challenges in administration and adherence where fixed-dose combination such as basal insulin plus GLP-1 RA may improve safety, effectiveness and acceptability. In this narrative review, we summarized the efficacy and safety data from randomized controlled trials using iGlarLixi, a fixed-ratio combination of insulin glargine 100 U/mL (iGlar) and lixisenatide (Lixi), a short acting GLP-1 RA, studied widely in Asians. We discussed the guidelines on the use of this fixed-ratio combination illustrated by real-world case studies in older Asian adults with young-onset type 2 diabetes."}