Glipulin reduced glycemic variability, weight, and some cardiometabolic risk, and also maintained A1c control vs basal-bolus insulin (BBI), according to a study involving 102 individuals.

All participants had been taking metformin and basal insulin. They were randomized to also receive exenatide or to continue with rapid-acting insulin. Investigators looked at glycemic variance, hypoglycemia, weight, risk markers, and cardiac arrhythmias. Among the results:

• Median A1c was 7.3% for people taking glipulin and 7.4% for those receiving BBI.

• Glucose variations were also similar in both groups.

• At 26 weeks, A1C levels remained similar, but average glucose coefficients of variation improved with glipulin (-2.4) vs BBI (0.4).

• There were no differences in hypoglycemic events or arrhythmias.

• Body weight, alanine aminotransferase, and serum amyloid A were all better in the glipulin group.

Citation: Probstfield J, Hirsch I, O’Brien K, et al. Glucose variability in a 26-week randomized comparison of mealtime treatment with rapid-acting insulin versus glp-1 agonist in participants with type 2 diabetes at high cardiovascular risk. [Published online ahead of print April 19, 2016]. Diabetes Care. doi:10.2337/dc15-2782.