When should fixed ratio basal insulin/glucagon-like peptide-1 receptor agonists combination products be considered?

Diabetes management with achievement and maintenance of good glycemic control is very challenging in patients requiring multiple daily injections. This article is focusing on broader use of recently approved fixed ratio combination therapies, basal insulin and glucagon-like peptide-1 receptor agonists (GLP1 RA). These combination therapy improve patient compliance and adherence with the therapy, decrease burden of multiple injection, target multiple abnormalities in the pathophysiology of diabetes, decrease postprandial hypoglycemia, assist in weight loss and decrease weight related comorbidities. These combinations were recently approved for use as first injectables after failure of oral agents. Review of combination treatment with existing fixed doses of basal insulin with GLP1 RA opens door for further clinical trials for other dose combinations that can be used, particularly for patients who need higher doses of insulin.