Adults who underwent partial pancreatectomy and went on to develop type 2 diabetes experienced improved blood glucose and weight loss with combination therapy of insulin and Lyxumia, according to research in the Journal of Diabetes Investigation.

Toru Kitazawa, MD, of the Tokyo Metropolitan Cancer and Infectious Diseases Center at Komagome Hospital, Japan, and colleagues analyzed data from 10 adults with type 2 diabetes who had undergone a partial pancreatectomy (eight men; mean age, 70.2 years; mean BMI, 20.53 kg/m²). Within the cohort, eight patients had pancreatic cancer; two patients had a duodenal tumor. The average time from pancreatectomy to starting lixisenatide/insulin therapy was 470.3 days.

All patients were monitored at the hospital, where insulin doses were adjusted at baseline to achieve target fasting plasma glucose levels between 100 mg/dL and 130 mg/dL; Lyxumia (lixisenatide, Sanofi) was added once target levels were achieved and continued for 12 weeks. Insulin was administered at bedtime.

Researchers measured plasma glucose levels and C-peptide immunoreactivity before breakfast, 1 hour after breakfast and 2 hours after breakfast; HbA1c and body weight were measured at baseline and 12 weeks. Patients also underwent a CT scan to measure visceral and subcutaneous fat.

After 12 weeks of combination therapy, average HbA1c levels decreased from 8.46% at baseline to 6.81%, with eight of 10 patients achieving an HbA1c of less than 7% (P < .001). One-hour and 2-hour postprandial glucose also significantly decreased from 222.9 mg/dL and 247.5 mg/dL at baseline to 125.1 mg/dL and 115.1 mg/dL, respectively. Patients also lost an average of 4.1 kg after 12 weeks of combination therapy. There were no recorded incidents of hypoglycemia or other relevant adverse events, according to researchers.

“Although this was a single-arm study with a small study population, it is suggested that combination therapy with basal insulin and short-acting [glucagon-like peptide-1] receptor agonists can be a useful therapeutic option to achieve good glucose control for patients who develop diabetes after partial pancreatectomy,” the researcher wrote. “More patients need to be selected and evaluated on a long-term basis. – by Regina Schaffer