Effect of Beta‐Cell Function on Glucose Variability When Switching From Insulin Degludec Plus a Dipeptidyl Peptidase‐4 Inhibitor to Insulin Degludec/Liraglutide: Preliminary Results From a Pilot Study

For patients with diabetes, achieving stable glucose control with minimal variability is highly significant. Incretin drugs have been shown to improve glycemic variability (GV), and we recently showed that a switch from a combination of a dipeptidyl peptidase (DPP)‐4 inhibitor plus basal insulin to insulin degludec/liraglutide (IDegLira) improves GV, including the mean amplitude of glycemic excursions (MAGE), using continuous glucose monitoring in hospitalized patients with Type 2 diabetes. Here, we performed a secondary analysis to identify the factors related to an improvement in MAGE when switching to IDegLira. In patients with high MAGE, the change in C‐peptide immunoreactivity during a glucagon test (ΔCPR) showed the highest correlation with the change in MAGE among the baseline patients’ characteristics ( ρ = −0.70; p < 0.05). Regression analysis confirmed a significant association between preserved CPR and amelioration of MAGE ( R 2 = 0.45; p < 0.05). Thus, this preliminary result implies that a treatment strategy that includes a glucagon‐like peptide‐1 receptor agonist might be beneficial for patients being treated with a DPP‐4 inhibitor plus basal insulin who show high GV but have preserved beta‐cell function.