Trial reportJournal of diabetes2022

DUAL I China: Improved glycemic control with IDegLira versus its individual components in a randomized trial with Chinese participants with type 2 diabetes uncontrolled on oral antidiabetic drugs.

Weiqing Wang, Bue F Ross Agner, Bin Luo, Lei Liu, Ming Liu, Yongde Peng, Shen Qu, Karolina Amelia Stachlewska, Guixia Wang, Guoyue Yuan and 2 more

Erratum issued Registry-linked trialOpen access · goldFull text readClinical Trial, Phase IIIMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Journal of diabetes, 2022. The graph read 2 numbers from its abstract, feeding 3 cells of the map, but none could be read as for or against, so it casts no vote. An erratum has been issued. It reports registered trial NCT03172494. Cited by 15 papers, 3 of them syntheses that pooled it.

2numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 3 pooled it
3.3field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

Read, but not usablea number the graph found but could not read as for or against

Hypoglycaemiacomparator not stated · t2dfeeds one cell of the map
IRR 1.460.71 to 3.02P = .3008
Severe or confirmed hypoglycemic event rates were 0.24 (IDegLira) and 0.17 (degludec) episodes/participant-year (estimated rate ratio 1.46; 95% CI 0.71, 3.02; P = .3008, not significant).
Glycemic controlcomparator not stated · t2dfeeds 2 cells of the map
Δ -6.50-7.96 to -5.04P < .0001
RESULTS: At 26 weeks, HbA1c had decreased by a mean 18.12 mmoL/moL (IDegLira), 12.37 mmoL/moL (degludec) (estimated treatment difference [ETD] -6.50 mmoL/moL; 95% confidence interval [CI] -7.96, -5.04; P < .0001), and 11.33 mmoL/moL (liraglutide) (ETD -6.87 mmoL/moL; 95% CI -8.33, -5.41; P < 0.0001), indicating noninferiority for IDegLira vs degludec and superiority vs liraglutide.

clause the extractor read what became the number

2 · Its place on the map

Where it lands on the map

Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.

supports the treatmentfavours the comparatorno clear differenceread, but no usable result
3 · What it changes

What it adds to each cell

For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.

GLP-1 receptor agonists×glycemic control

No readable resultOpen on the map →What to test next →

40 readable studies in this cell: 96 favour the treatment, 17 find no difference, 10 favour the comparator.

Belief with this paper
0.91replicated · 68 families support, 7 contradict · against placebo
Without it
0.91This paper does not move the number.
← favours the treatmentfavours the comparator →
0 · no effect
This paper’s trial, registry resultNCT03172494 · 720 enrolled · 2017
Δ -0.59-0.73 to -0.46
NCT017204463,297 enrolled · 2013
Δ -0.66-0.80 to -0.52
NCT036893742,274 enrolled · 2018
Δ -0.29-0.38 to -0.20
NCT039879191,879 enrolled · 2019
Δ -0.51-0.64 to -0.38
NCT026078651,864 enrolled · 2016
Δ -0.50-0.60 to -0.40
NCT013360231,663 enrolled · 2011
Treatment contrast -0.64-0.75 to -0.53
NCT040178321,441 enrolled · 2019
Δ -0.20-0.30 to -0.10
NCT018365231,398 enrolled · 2013
Δ -0.20-0.32 to -0.07
NCT019301881,231 enrolled · 2013
Δ -1.06-1.21 to -0.91
NCT007344741,202 enrolled · 2008
Δ -0.71-0.87 to -0.55
NCT020581471,170 enrolled · 2014
Δ -0.29-0.38 to -0.19
NCT003184611,091 enrolled · 2006
Δ -1.09-1.30 to -0.88
NCT021289321,089 enrolled · 2014
Δ -0.81-0.96 to -0.67

Insulin×hypoglycaemia

No readable resultOpen on the map →What to test next →

4 readable studies in this cell: 2 favour the treatment, 1 find no difference, 1 favour the comparator.

Belief with this paper
0.00contested · 0 families support, 3 contradict · head-to-head
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the comparatorfavours the treatment →
1 · no effect
NCT045379231,428 enrolled · 2020
OR 8.195.66 to 11.8
NCT02551874650 enrolled · 2015
OR 0.400.30 to 0.62

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

Insulin×glycemic control

No readable resultOpen on the map →What to test next →

40 readable studies in this cell: 15 favour the treatment, 14 find no difference, 14 favour the comparator.

Belief with this paper
0.50contested · 9 families support, 6 contradict · against placebo
Without it
0.50This paper does not move the number.
← favours the treatmentfavours the comparator →
0 · no effect
This paper’s trial, registry resultNCT03172494 · 720 enrolled · 2017
Δ -0.63-0.76 to -0.49
NCT036893742,274 enrolled · 2018
Δ -0.29-0.38 to -0.20
NCT037306622,002 enrolled · 2018
Δ -0.99-1.13 to -0.86
NCT013360231,663 enrolled · 2011
Treatment contrast -0.64-0.75 to -0.53
NCT038829701,444 enrolled · 2019
Δ -0.86-1.00 to -0.72
NCT045379231,428 enrolled · 2020
Δ -1.10-1.24 to -0.97
NCT032680051,264 enrolled · 2017
Δ -0.04-0.11 to 0.03
NCT020581471,170 enrolled · 2014
Δ -0.78-0.90 to -0.67
NCT021289321,089 enrolled · 2014
Δ -0.81-0.96 to -0.67
NCT009606611,036 enrolled · 2009
Δ -0.04-0.18 to 0.11
NCT00856986987 enrolled · 2009
Δ -0.52-0.68 to -0.36
NCT01117350978 enrolled · 2010
Δ 2.54-3.88 to 8.93
NCT03214380933 enrolled · 2017
Δ 0.06-0.05 to 0.16
4 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03172494 phase3completed

A Trial Comparing the Efficacy and Safety of Insulin Degludec/Liraglutide, Insulin Degludec, and Liraglutide in Chinese Subjects With Type 2 Diabetes Inadequately Controlled on Oral Antidiabetic Drugs (OADs)

Ran2017Enrolled720Registered outcomes62Posted comparisons2ConditionsDiabetes, Diabetes Mellitus, Type 2Armsinsulin degludec, insulin degludec/liraglutide, liraglutide
Open the trial in the graph
5 · Its place in the literature

Who cites it

15 citing papers in PubMed, 3 syntheses or guidelines pooled it, 16 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Trial
  5. Trial
  6. Article
  7. Review
  8. Article
  9. Article
  10. Article
  11. Treatment Patterns and Glycaemic Control Between 2015 and 2019 in Tianjin, China: A Real-World Study of Adults with Type 2 Diabetes.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2025
    Article
  12. Review
  13. Article
  14. Article
  15. Article
6 · The record

Corrections and comments

7 · Who and what money

Authors and funding

12 authors at 9 institutions in 4 countries.

Weiqing WangDepartment of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Bue F Ross AgnerBispebjerg Hospital, Copenhagen, Denmark.
Bin LuoNovo Nordisk China Pharmaceuticals, Beijing, China.
Lei LiuNovo Nordisk A/S, Søborg, Denmark.
Ming LiuDepartment of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China.
Yongde PengDepartment of Endocrinology and Metabolism, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China.
Shen QuDepartment of Endocrinology and Metabolism, Shanghai Tenth People's Hospital of Tongji University, Shanghai, China.
Karolina Amelia StachlewskaNovo Nordisk A/S, Søborg, Denmark.
Guixia WangDepartment of Endocrinology and Metabolism, The First Hospital of Jilin University, Jilin, China.
Guoyue YuanDepartment of Endocrinology and Metabolism, Affiliated Hospital of Jiangsu University, Zhenjiang, China.
Qiu ZhangDepartment of Endocrinology and Metabolism, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
Guang NingDepartment of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.ORCID https://orcid.org/0000-0002-5754-7635
Shanghai Jiao Tong University · CNNovo Nordisk (Denmark) · DKAnhui Medical University · CNBispebjerg Hospital · DKJiangsu University · CNJilin University · CNNovo Nordisk (Finland) · FITianjin Medical University General Hospital · CNTongji University · CN

Funding

Novo Nordisk n/a
8 · The paper itself

Abstract

The marked sentences are the ones the graph read a number from.

backgroundDUAL I China, one of the DUAL trials, assessed efficacy/safety of insulin degludec/liraglutide (IDegLira) in Chinese adults with type 2 diabetes (T2D) not controlled by oral antidiabetic drugs (OADs).

methodsThis phase 3a, treat-to-target multicenter trial randomized participants (glycated hemoglobin [HbA1c] 53.0-85.8 mmol/mol; previous metformin ± another OAD) 2:1:1 to IDegLira (n = 361), degludec (n = 179), or liraglutide (n = 180). Primary endpoint was change in HbA1c after 26 weeks. Secondary endpoints included: HbA1c < 53.0 mmol/mol attainment, weight change, treatment-emergent hypoglycemia, end-of-treatment insulin dose, and safety.

resultsAt 26 weeks, HbA1c had decreased by a mean 18.12 mmoL/moL (IDegLira), 12.37 mmoL/moL (degludec) (estimated treatment difference [ETD] -6.50 mmoL/moL; 95% confidence interval [CI] -7.96, -5.04; P < .0001), and 11.33 mmoL/moL (liraglutide) (ETD -6.87 mmoL/moL; 95% CI -8.33, -5.41; P < 0.0001), indicating noninferiority for IDegLira vs degludec and superiority vs liraglutide. HbA1c < 53.0 mmoL/moL attainment was 77.0% (IDegLira), 46.4% (degludec), and 48.3% (liraglutide). Mean weight change with IDegLira (0.1 kg) was superior to degludec (1.2 kg) (ETD -1.08 kg; 96% CI -1.55, -0.62; P < 0.0001). Severe or confirmed hypoglycemic event rates were 0.24 (IDegLira) and 0.17 (degludec) episodes/participant-year (estimated rate ratio 1.46; 95% CI 0.71, 3.02; P = .3008, not significant). At the end of treatment, the IDegLira insulin dose was lower (24.5 U/d) vs degludec (30.3 U/d) (ETD -5.49 U; 95% CI -7.77, -3.21; P < 0.0001). No unexpected safety issues occurred.

conclusionsIDegLira is efficacious and well tolerated in Chinese adults with T2D not controlled by OADs.

Indexed as

Diabetes Mellitus, Type 2Insulin, Long-ActingLiraglutideAdultBlood GlucoseChinaDrug CombinationsGlycated HemoglobinGlycemic ControlHumansHypoglycemic AgentsInsulinBlood GlucoseDrug CombinationsGlycated HemoglobinHypoglycemic AgentsIDegLiraInsulininsulin degludecInsulin, Long-ActingLiraglutide2型糖尿病Chineseclinical trialinsulinliraglutidetype 2 diabetes中国临床试验利拉鲁肽胰岛素

Identifiers

PMID35762390
PMCPMC9366571
OpenAlexW4283662418

What Socratic holds

Textfull text, public
LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.