insulin degludec + insulin aspart + linagliptin + metformin

This combination therapy is an experimental treatment regimen developed and investigated by Huashan Hospital for patients with both liver cirrhosis and diabetes mellitus. The regimen integrates three distinct classes of glucose-lowering agents: a co-formulation of insulin degludec and insulin aspart (providing both basal and prandial insulin), the DPP-4 inhibitor linagliptin, and the biguanide metformin. This triple-therapy approach is designed to address the complex pathophysiology of 'hepatogenous diabetes,' where insulin resistance and impaired glucose metabolism occur alongside the risks of hypoglycemia and hepatic encephalopathy. By combining agents with different mechanisms—insulin replacement, incretin enhancement, and reduction of hepatic glucose output—the regimen aims to achieve stable glycemic control with a simplified dosing schedule compared to traditional intensive insulin therapy. It is currently being evaluated in a Phase 4 clinical trial (NCT04643431) to assess its efficacy and safety in the cirrhotic population.

Other names

metformin (Huashan Hospital)IDegAsp + linagliptin + metformininsulin degludec/insulin aspart + linagliptin + metforminRyzodeg + Trajenta + Metformin