Background: Two types of fixed-ratio combinations of basal insulin and a glucagon-like peptide-1 receptor agonist (GLP-1RA) have been approved for use in type 2 diabetes. One is insulin degludec/liraglutide (iDergLira), and the other is insulin glargine/lixisenatide (iGlarLixi). Direct comparisons between these two combination is not available. Methods: The retrospective study included 186 patients with type 2 diabetes mellitus (DM) with inadequate glycemic control on metformin and basal insulin (degludec, glargine 100, glargine 300) who were switched to fixed-ratio combination GLP-1 RA and basal insulin. Patients were divided into two groups based on the basal insulin before study: group I (n = 86) treated with degludec were switched to iDegLira and patients group II (n = 99), treated with glargine were switched to iGlarLixi. The aim of this study was to directly compare the effects between two fixed – ratio combination on glycemic parameters and non glycemic parameters. Follow up was 6 months. Results: Mean HbA1c decreased similarly (− 1.2% vs.-1.1%). Higher percentage patients in iDegLira group had reached the HbA1c < 7% after 6 months (22% vs. 18.2%, p < 0.05). The mean change in fasting plasma glucose (FPG) was comparable for the two groups, while mean decrease postprandial plasma glucose (PPG) level were lower in iGlarLixi group (2 vs 1.8 mmol/l, p > 0.05). Change in body weight was significant in iDegLira group (1.8 kg vs. 0.7 kg, p < 0.001). At the end of the study patients showed decrease in total cholesterol (TC) and low-density lipoprotein (LDL) for 0.2 mmol/L in iDegLira, 0.1 mmol/l in iGlarLixi, triglycerides decreased 0.3 mmol/l in both groups, high-density lipoprotein(HDL) increased 0.1 mm/l in iGlarLixi. Conclusion: Our results showed that more patients with iDegLira had HbA1c less than 7% and these combination had better effect on weight loss. There was no difference observed in FPG and PPG, lipid profile and rate of hypoglycemia.

Leptin is a protein hormone secreted by adipocytes. Its role in malnutrition-inflammation complex syndrome (MICS) in hemodialysis (HD) patients has not been fully resolved yet. We aimed to assess the predictive role of serum leptin in MICS in maint...

Fixed ratio combination of basal insulin and a glucagon-like peptide-1 receptor agonist (GLP-1RA) offers another option to patients with type 2 diabetes (T2DM) with inadequate glycemic control, especially for those desiring simplified method of treatment intensification in order to improve adherence. There are two types of fixed-ratio combinations: insulin degludec/liraglutide (iDergLira) and insulin glargine/lixisenatide (iGlarLixi). The aim of this study was to evaluate efficacy of intesifying the treatment with fixed ratio combination basal insulin and GLP-1 RA in patients inadequatly controlled on different therapeutic regimen. The study included 200 patients with uncontrolled T2DM, who were divided into four equal groups based on the therapeutic regimen before study: oral diabetic agents or metformin and basal insulin or metformin and GLP 1RA or premix insulin. Our results showed that fixed ratio combination showed better efficiency of on glycemic control in patients previously treated with oral agents and premix insulin, while patients previously treated with premix insulin have had the greatest benefit regarding weight change. We found no difference in glycemic control between iDegLira and iGlarLixi, but significant difference in weight reduction between iDegLira and iGlarLixi.

Introduction: Obesity is a central pathophysiological factor that links reduced lung function and the severity of obstructive sleep apnea. The aim: To analyze the association between obesity, lung function, and the severity of obstructive sleep apnea (OSA). Methods: A retrospective study was conducted in 28 hospitalized patients at the Clinic for pulmonary diseses of the University Clinical Center of the Republic of Srpska with suspected sleep-disordered breathing. Lung function was assessed by spirometry (forced exiratory volume in 1 second (FEV1), forced vital capacity FVC, FEV1/FVC ratio), while sleep-disordered breathing was diagnosed by nocturnal polygraphy with determination of apnea-hypopnea index (AHI) and oxygen desaturation index (ODI). Results: The subjects were of average age 50 years, predominantly male (68%), with a high average body mass index (BMI) of 40.4 kg/m². The results showed statistically significant positive correlation between BMI and AHI (r = 0.38), as well as a very strong correlation between AHI and ODI (r = 0.91). Negative correlations were observed between AHI and FEV1 (r = -0.45) and FVC (r = -0.40), as well as between BMI and spirometric parameters. Conclusion: Obesity significantly contributes to the reduction of lung function and the severity of OSA.