Efficacy and Safety of Basal Insulin Combined with GLP-1 Receptors Agonists versus Intensified Conventional Insulin Regimens in Type 2 Diabetes: A Meta Analysis of Randomized Controlled Trials

Sarah Musallam Albishri; Reema Alshaya; Eyas Alharbi; Alshayma Alharbi; Lujain Alharbi; Muath Alferadi; Yara Alfuraydi; Ahmed Alzahrani; Mathahir Almeshal; Rand Alqahtani; Khalid Abdulrahman Althobaiti

doi:10.24911/IJMDC.51-1785039096

2026, Vol: 10, Issue: 9

10 / 9Current Issue Online First Archive Aims and Scope Abstracting & Indexing Most Accessed Articles Most Downloaded Articles Most Cited Articles

« Previous Article

Review Article
Online Published: 09 Sep 2026

IJMDC. 0; 0(0):

doi: 10.24911/IJMDC.51-1785039096

Efficacy and Safety of Basal Insulin Combined with GLP-1 Receptors Agonists versus Intensified Conventional Insulin Regimens in Type 2 Diabetes: A Meta Analysis of Randomized Controlled Trials

Sarah Musallam Albishri, Reema Alshaya, Eyas Alharbi, Alshayma Alharbi, Lujain Alharbi, Muath Alferadi, Yara Alfuraydi, Ahmed Alzahrani, Mathahir Almeshal, Rand Alqahtani, Khalid Abdulrahman Althobaiti.

Abstract
Background / Aim: In Type 2 diabetes, Multiple Daily Injection (MDI) is effective but associated with hypoglycemia, weight gain, and poor adherence. Despite the growing endorsement of basal insulin plus GLP-1 receptor Agonist (GLP-1RA) as a streamlined therapeutic step-down, a pooled synthesis that encompasses every published randomized controlled trial investigating this comparator remains absent from the literature.
Methods / Materials: A systematic review with meta-analysis was performed in line with PRISMA 2020 standards, and its protocol was prospectively registered in PROSPERO. Electronic searches were executed across PubMed, Scopus, Web of Science, and Cochrane Central with time horizon extending from database inception to the cut-off date of April 2026. Randomized controlled trials comparing de-intensification from MDI to basal insulin plus a GLP-1RA with continuation of MDI in diabetic type 2 adults were included. Pairwise meta-analyses were performed using random-effects models. Trial sequential analysis was applied to assess the sufficiency of accrued evidence. Using the GRADE System, we evaluated the level of certainly across the pooled effect estimates. PROSPERO ID: CRD420261443671.
Results: Seven trials (1,397 patients) were included. There was no significant difference in HbA1c change between strategies (MD −0.01 percentage points; 95% CI −0.10 to 0.09; high certainty). The GLP-1RA-based strategy significantly reduced body weight (MD −3.53 kg; 95% CI −4.56 to −2.49; moderate certainty), total daily insulin dose (MD −33.47 units/day; 95% CI −47.00 to −19.95; very low certainty), and hypoglycemia risk (RR 0.67; 95 % CI 0.45 – 0.98; moderate certainty). Gastrointestinal adverse events were more frequent with the GLP-1RA-based regimen (RR 2.29; 95% CI 1.27–4.15; high certainty). Overall adverse event rates were similar between groups.
Conclusion: For adults with type 2 diabetes, substituting MDI with a basal insulin–GLP-1RA combination sustains glycemic targets while mitigating weight gain, lowering insulin consumption, and attenuating hypoglycemic episodes—thereby reinforcing its role as an effective and safe simplification strategy.

Key words: Type 2 diabetes; GLP-1 receptor agonist; basal insulin; multiple daily injections; insulin de-intensification; HbA1c; hypoglycemia

	ARTICLE TOOLS
	Abstract
	PDF Fulltext
	How to cite this article
	Citation Tools
	Related Records
	Articles by Sarah Musallam Albishri Articles by Reema Alshaya Articles by Eyas Alharbi Articles by Alshayma Alharbi Articles by Lujain Alharbi Articles by Muath Alferadi Articles by Yara Alfuraydi Articles by Ahmed Alzahrani Articles by Mathahir Almeshal Articles by Rand Alqahtani Articles by Khalid Abdulrahman Althobaiti
	on Google
	on Google Scholar

How to Cite this Article

Pubmed Style

Albishri SM, Alshaya R, Alharbi E, Alharbi A, Alharbi L, Alferadi M, Alfuraydi Y, Alzahrani A, Almeshal M, Alqahtani R, Althobaiti KA. Efficacy and Safety of Basal Insulin Combined with GLP-1 Receptors Agonists versus Intensified Conventional Insulin Regimens in Type 2 Diabetes: A Meta Analysis of Randomized Controlled Trials. IJMDC. Online First: 09 Sep, 2026. doi:10.24911/IJMDC.51-1785039096

Web Style

Albishri SM, Alshaya R, Alharbi E, Alharbi A, Alharbi L, Alferadi M, Alfuraydi Y, Alzahrani A, Almeshal M, Alqahtani R, Althobaiti KA. Efficacy and Safety of Basal Insulin Combined with GLP-1 Receptors Agonists versus Intensified Conventional Insulin Regimens in Type 2 Diabetes: A Meta Analysis of Randomized Controlled Trials. https://www.ijmdc.com/?mno=329009 [Access: September 09, 2026]. doi:10.24911/IJMDC.51-1785039096

AMA (American Medical Association) Style

Albishri SM, Alshaya R, Alharbi E, Alharbi A, Alharbi L, Alferadi M, Alfuraydi Y, Alzahrani A, Almeshal M, Alqahtani R, Althobaiti KA. Efficacy and Safety of Basal Insulin Combined with GLP-1 Receptors Agonists versus Intensified Conventional Insulin Regimens in Type 2 Diabetes: A Meta Analysis of Randomized Controlled Trials. IJMDC. Online First: 09 Sep, 2026. doi:10.24911/IJMDC.51-1785039096

Vancouver/ICMJE Style

Albishri SM, Alshaya R, Alharbi E, Alharbi A, Alharbi L, Alferadi M, Alfuraydi Y, Alzahrani A, Almeshal M, Alqahtani R, Althobaiti KA. Efficacy and Safety of Basal Insulin Combined with GLP-1 Receptors Agonists versus Intensified Conventional Insulin Regimens in Type 2 Diabetes: A Meta Analysis of Randomized Controlled Trials. IJMDC, [cited September 09, 2026]; Online First: 09 Sep, 2026. doi:10.24911/IJMDC.51-1785039096

Harvard Style

Albishri, S. M., Alshaya, . R., Alharbi, . E., Alharbi, . A., Alharbi, . L., Alferadi, . M., Alfuraydi, . Y., Alzahrani, . A., Almeshal, . M., Alqahtani, . R. & Althobaiti, . K. A. (0) Efficacy and Safety of Basal Insulin Combined with GLP-1 Receptors Agonists versus Intensified Conventional Insulin Regimens in Type 2 Diabetes: A Meta Analysis of Randomized Controlled Trials. IJMDC, Online First: 09 Sep, 2026. doi:10.24911/IJMDC.51-1785039096

Turabian Style

Albishri, Sarah Musallam, Reema Alshaya, Eyas Alharbi, Alshayma Alharbi, Lujain Alharbi, Muath Alferadi, Yara Alfuraydi, Ahmed Alzahrani, Mathahir Almeshal, Rand Alqahtani, and Khalid Abdulrahman Althobaiti. 0. Efficacy and Safety of Basal Insulin Combined with GLP-1 Receptors Agonists versus Intensified Conventional Insulin Regimens in Type 2 Diabetes: A Meta Analysis of Randomized Controlled Trials. International Journal of Medicine in Developing Countries, Online First: 09 Sep, 2026. doi:10.24911/IJMDC.51-1785039096

Chicago Style

Albishri, Sarah Musallam, Reema Alshaya, Eyas Alharbi, Alshayma Alharbi, Lujain Alharbi, Muath Alferadi, Yara Alfuraydi, Ahmed Alzahrani, Mathahir Almeshal, Rand Alqahtani, and Khalid Abdulrahman Althobaiti. "Efficacy and Safety of Basal Insulin Combined with GLP-1 Receptors Agonists versus Intensified Conventional Insulin Regimens in Type 2 Diabetes: A Meta Analysis of Randomized Controlled Trials." International Journal of Medicine in Developing Countries Online First: 09 Sep, 2026. doi:10.24911/IJMDC.51-1785039096

MLA (The Modern Language Association) Style

Albishri, Sarah Musallam, Reema Alshaya, Eyas Alharbi, Alshayma Alharbi, Lujain Alharbi, Muath Alferadi, Yara Alfuraydi, Ahmed Alzahrani, Mathahir Almeshal, Rand Alqahtani, and Khalid Abdulrahman Althobaiti. "Efficacy and Safety of Basal Insulin Combined with GLP-1 Receptors Agonists versus Intensified Conventional Insulin Regimens in Type 2 Diabetes: A Meta Analysis of Randomized Controlled Trials." International Journal of Medicine in Developing Countries Online First: 09 Sep, 2026. Web. 09 Sep 2026 doi:10.24911/IJMDC.51-1785039096

APA (American Psychological Association) Style

Albishri, S. M., Alshaya, . R., Alharbi, . E., Alharbi, . A., Alharbi, . L., Alferadi, . M., Alfuraydi, . Y., Alzahrani, . A., Almeshal, . M., Alqahtani, . R. & Althobaiti, . K. A. (0) Efficacy and Safety of Basal Insulin Combined with GLP-1 Receptors Agonists versus Intensified Conventional Insulin Regimens in Type 2 Diabetes: A Meta Analysis of Randomized Controlled Trials. International Journal of Medicine in Developing Countries, Online First: 09 Sep, 2026. doi:10.24911/IJMDC.51-1785039096

Most Viewed Articles

Most Accessed Articles

Marginal adaptation of fixed prosthodontics
Shahad Mohammed Halawani, Sahar Amer Al-Harbi
IJMDC. 2017; 1(2): 78-84
» Abstract » doi: 10.24911/IJMDC.1.2.7

Parasites in central nervous system
Amal Ahmed Mohamed, Asmaa Mohamed Mansour
IJMDC. 2017; 1(2): 72-77
» Abstract » doi: 10.24911/IJMDC.1.2.6

Non-diabetic retinopathy: a case report
Hassan F. Alkwikbi, Nabil Mamon Abdelfattah, Haithem Mamon Abdelfattah
IJMDC. 2017; 1(1): 33-37
» Abstract » doi: 10.24911/IJMDC.1.1.6

Vitamin D deficiency among high school female students in Riyadh
Sahar Mohsen Aldhafeeri, Fatemah Ibraheem Alrawaji, Abrar Mubarak Algharbi, Alanoud Abdullah Alhessan, Ayat Sami Qabaja, Ghaleah Abdulaziz Alnassar, Ghaliah Ofayn Alsulami, Mashael Belal Alrubaian, Norah Abdulaziz Alhatim, Salehah Salih Alotaibi, Zahra Ali Alkhamees
IJMDC. 2017; 1(1): 18-23
» Abstract » doi: 10.24911/IJMDC.1.1.4

Prognosis of chronic complications of diabetes mellitus (DM) after multiple events of diabetic ketoacidosis (DKA)
Baraa Faiez Rajab, Anwar Essa Alamrim, Ali Essa Alamri
IJMDC. 2019; 3(5): 474-479
» Abstract » doi: 10.24911/IJMDC.51-1546551993

Most Downloaded

Top Downloaded Articles

Perception and attitude of medical students towards trauma and orthopedic teaching: a cross-sectional study
Nawaf Hameed Almohammadi, Faisal Ali Almesned, Atif Omar Alhawsah, Sami Aoudah Alahmari, Madloul Jassim Alshammari, Hamad Ali Alkhunayfir
IJMDC. 2019; 3(6): 503-508
» Abstract » doi: 10.24911/IJMDC.51-1548706801

Anti-IL-17 markedly inhibited the in vitro granuloma induced by Schistosoma mansoni soluble egg antigen.
Asmaa Ezz, Irene S. Gmail, Fatma Elzahraa H. Salem, Rabab Salama, Soad Nady
IJMDC. 2018; 2(January 2018): 38-46
» Abstract » doi: 10.24911/IJMDC.2.1.7

Antibiotic Resistance Crisis
Nuha Saad Mobarki, Buthaina Abdullah Almerabi, Ahmad Hattan Hattan
IJMDC. 2019; 3(6): 561-564
» Abstract » doi: 10.24911/IJMDC.51-1549060699

Marginal adaptation of fixed prosthodontics
Shahad Mohammed Halawani, Sahar Amer Al-Harbi
IJMDC. 2017; 1(2): 78-84
» Abstract » doi: 10.24911/IJMDC.1.2.7

Most Cited Articles

Most Cited Articles

Antibiotic Resistance Crisis
Nuha Saad Mobarki, Buthaina Abdullah Almerabi, Ahmad Hattan Hattan
IJMDC. 2019; 3(6): 561-564
» Abstract » doi: 10.24911/IJMDC.51-1549060699
Cited : 34 times [Click to see citing articles]

Prevalence of depression, anxiety and stress among diabetes mellitus patients in Arar, Northern Saudi Arabia
AMohammed Elamin Mukrim, Nujud Muteb D. Alshammari, Wurud Muteb D. Alshammari, Maali Subhi T. Alshammari, Yousef Nasif R. Alshammari, Abdulaziz Sael M. Alshammari, Maisa Hamad F. Alanazi, Abdulelah Abdulrhman F. Alzammam, Muharib Mana M. Alshammari, Slwa Khaled Abu Asyah, Aseel Jamal Alzuhayri, Mushref Saeid Alshammari
IJMDC. 2019; 3(3): 229-233
» Abstract » doi: 10.24911/IJMDC.51-1542576396
Cited : 8 times [Click to see citing articles]

Knowledge, attitude, and practice of breast self-examination toward breast cancer among female students at King Saud University in Riyadh, Saudi Arabia
Abdullah Nasser Alomair, Dania Ghazi Felemban, Mohannad Sami Felemban, Jameel Abdullah Awadain, Ammar Saud Altowairqi, Nawaf Fawzan Alfawzan, Fatimah Mohammed Almazayen, Abdulrahman Jalwi Korkoman, Nawaf Saad Alrusayyis
IJMDC. 2020; 4(2): 429-434
» Abstract » doi: 10.24911/IJMDC.51-1576668182
Cited : 8 times [Click to see citing articles]

Population awareness about rheumatoid arthritis in Jazan region, Saudi Arabia
Ahmad Ali Hazzazi, Mohssen Hassen Ageeli, Ahmed Ali Muyidi, Abdulaziz Mohammad Abulgasim, Abdullah Ahmad Yateemi, Nabil Alhakami
IJMDC. 2020; 4(3): 668-675
» Abstract » doi: 10.24911/IJMDC.51-1576010943
Cited : 4 times [Click to see citing articles]

Prevalence and factors associated with depression among health care workers in National Guard Hospital in Riyadh, KSA
Noor Mohammad AlFahhad
IJMDC. 2018; 2(September 2018): 92-96
» Abstract » doi: 10.24911/IJMDC.51-1526306040
Cited : 4 times [Click to see citing articles]

Effect of inter-pregnancy interval on pregnancy outcome: a prospective study at Fayoum, Egypt
Eman M. Mahfouz, Naglaa A. El-Sherbiny, Wafaa Y. Abdel Wahed, Nashwa S. Hamed
IJMDC. 2018; 2(May 2018): 38-44
» Abstract » doi: 10.24911/IJMDC.51-1520268317
Cited : 4 times [Click to see citing articles]

Diabetic neuropathy in Saudi Arabia: a comprehensive review for further actions
Mohammad Mater Aljohani, Amjad Taj Karam, Ayman Abdulaziz Alamri, Mohammed Hamed Manfaloti, Hussain Abbas Alnakhli, Hatem Ahmed Shaqroon
IJMDC. 2020; 4(11): 2008-2013
» Abstract » doi: 10.24911/IJMDC.51-1601343665
Cited : 4 times [Click to see citing articles]

Public Awareness of coronary artery disease risk factors in Qassim, Saudi Arabia: a cross-sectional study
Abdullah Muzil Albadrani, Saleh Sulaiman Al-Ajlan, Abdullah Saer E. Alharbi, Abdulelah Saud Alharbi, Saif Mohammed Radhi Alharbi
IJMDC. 2020; 4(3): 593-599
» Abstract » doi: 10.24911/IJMDC.51-1572217065
Cited : 4 times [Click to see citing articles]

Ischemic stroke: prevalence of modifiable risk factors in the Saudi population
Muhannad Noor Alharbi, Atheer Khalid Alharbi, Mousa Atqan Alamri, Abdulmalik Ayedh Saad Alharthi, Abdulrahman Moneer Alqerafi, Mohamed Noor Alharbi
IJMDC. 2019; 3(7): 601-603
» Abstract » doi: 10.24911/IJMDC.51-1548376707
Cited : 3 times [Click to see citing articles]

Prevalence and risk factors for diabetic nephropathy in type 2 diabetic patients, Taif City, Saudi Arabia
Basel Saad Alzahrani, Turki Hamdan Alzidani, Abdullah Mohammed Alturkistani, Hani Abozaid
IJMDC. 2019; 3(2): 167-172
» Abstract » doi: 10.24911/IJMDC.51-1541336905
Cited : 3 times [Click to see citing articles]

Assessment of knowledge and awareness regarding thyroid disorders among Saudi people
Assem Saleh Ali Almuzaini , Bayan ahmad I Alshareef , Sundos Hamoud O Alghamdi, Ayman Adnan Munshy, Abdulmajeed Khalid M. Aljarallah, Saud Abdulaziz A Salman, Khalid Saud Alroqi, Reem Dayel A Alkhaldi
IJMDC. 2019; 3(12): 1070-1076
» Abstract » doi: 10.24911/IJMDC.51-1568037206
Cited : 3 times [Click to see citing articles]

Assessment of knowledge, attitude, and practice in relation to use of isotretinoin among Al-Madinah population, Saudi Arabia
Amr Molla, Hassan Abdullah Alrizqi, Emtinan Mohammed Salem Alruhaili, Saad Abdullah Alrizqi, Arwa Musaad Alsubhi
IJMDC. 2020; 4(1): 107-112
» Abstract » doi: 10.24911/IJMDC.51-1571752077
Cited : 3 times [Click to see citing articles]

Ethical considerations in doctors & pharmaceutical industries relationship: a narrative review
Mohammed Saud Almasri, Yousef Rafat Bukhari, Bandar Saleh Alzuair, Mansour Khalid Almadi, Amro Khalid Bin Abdulrahman
IJMDC. 2020; 4(1): 244-252
» Abstract » doi: 10.24911/IJMDC.51-1572794591
Cited : 3 times [Click to see citing articles]

Assessment of the knowledge of pregnant women regarding the effects of GDM on mothers and neonates at a Maternal and Children hospital in Najran, Saudi Arabia
Amina Abdo Salhi, Medical Intern, Majed Saeed Alshahrani, Maram Mohammed Alyamin, Waad Ahmed Hamdi, Sarah Raja Alyami, Albatool Saleh Almagbool, Nujoud Hamad Almoqati, Seham Hamad Almoqati, Esra'a Amer Nasser Al-Saaed, Hessa Salem Al Habes, Batool Mubarak Abdullah Alwdei, Ahlam Yhya Saeed Alyami, Wesal Ahmed Alassiri
IJMDC. 2019; 3(4): 370-375
» Abstract » doi: 10.24911/IJMDC.51-1545817090
Cited : 3 times [Click to see citing articles]

Awareness of the Saudi population about the role of the Emergency Rooms
Zead Ibrahim A. Alhussain, Mohammed Ali A. Alghamdi, Rana Mohamed Ahmed, Abdullah Yahya Aldhban, Abdulrahman Ali Alghamdi, Naif Shalan J. Alalyani
IJMDC. 2019; 3(11): 957-962
» Abstract » doi: 10.24911/IJMDC.51-1568717752
Cited : 3 times [Click to see citing articles]

About International Journal of Medicine in Developing Countries

Contact Information

How to cite this article