Effect of Lixisenatide (Short-acting Glucagon-Like Peptide 1 Receptor Agonist) as an Add-on to Insulin in Lowering HbA1C among Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis

Objective: This systematic review and meta-analysis aimed to evaluate the effect of Lixisenatide, a short-acting glucagon-like peptide 1 receptor agonist, as an add-on therapy to insulin in patients with type 2 diabetes (T2DM). The primary outcome of interest was the change in HbA1c levels. Methods: A comprehensive literature search was conducted in major databases for relevant studies published up to the present. Seven studies were included in the quantitative data synthesis. The characteristics of the included studies, including intervention, design, duration, sample size, demographics, baseline characteristics, and outcome measures, were summarized in a descriptive manner. A pooled analysis was performed to assess the overall effect of Lixisenatide on HbA1c levels. Heterogeneity among the studies was evaluated, and sensitivity analyses were conducted when necessary. Results: The pooled analysis of the seven included studies demonstrated a significant reduction in HbA1c levels with Lixisenatide as an add-on therapy to insulin. The mean difference (MD) was -0.41% (95% CI: -0.55 to -0.28), indicating a clinically meaningful improvement in glycemic control. Although heterogeneity was observed among the studies (I² = 80%, p < 0.0001), the overall effect estimate remained consistent. Conclusion: Our systematic review and meta-analysis provide robust evidence supporting the efficacy of Lixisenatide as an add-on therapy to insulin in lowering HbA1c levels in patients with T2DM. The significant reduction in HbA1c levels indicates mproved long-term glucose control, which is associated with reduced risks of diabetes-related complications. Clinicians should consider incorporating Lixisenatide into the treatment regimen of patients with T2DM who require additional glycemic control beyond insulin monotherapy. Further research is needed to explore secondary outcomes and safety profiles associated with Lixisenatide in this patient population. Key words: lixisenatide , add on therapy, insulin , glp-1 receptor agonist, Type 2 diabetes