ArticleCureus2026
A Novel Approach to Managing "Double Diabetes" in a Pediatric Patient on Insulin Pump Therapy: An Off-Label Use of a Fixed-Ratio Insulin Degludec/Liraglutide Combination.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The convergence of type 1 diabetes (T1D) and features of type 2 diabetes, such as obesity and insulin resistance, has given rise to the concept of "double diabetes" (DD). This condition poses significant management challenges in the pediatric population, as escalating insulin requirements may exacerbate weight gain and insulin resistance, creating a vicious cycle. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are not approved for pediatric T1D but represent a potential therapeutic avenue. We present the case of an 11-year-old girl with antibody-positive T1D on an insulin pump who developed significant features of DD, including obesity, acanthosis nigricans, and escalating insulin requirements that exceeded her pump reservoir capacity. To address both insulin deficiency and severe insulin resistance, a novel off-label approach was initiated using a fixed-ratio combination of basal insulin degludec and the GLP-1 RA liraglutide (IDegLira), administered once daily as an adjunct to her continued insulin pump therapy for bolus insulin delivery. Over an eight-month follow-up period, the patient demonstrated modest weight loss (-2.2 kg) and a reduction in BMI z-score, with a marked improvement in glycemic control. Her mean glucose decreased from 196 mg/dL to 139 mg/dL, and her glucose management indicator improved from 8.0% to 6.6%. Time spent in severe hyperglycemia (>250 mg/dL) was reduced from 26% to 15%. The adjunctive therapy reduced the total daily insulin dose delivered via the pump. This case report highlights the potential utility of a pragmatic, off-label approach that combines a fixed-ratio GLP-1 RA with basal insulin to manage the challenges of pediatric DD. It addressed insulin resistance, improved glycemic control, and mitigated the burdensome cycle of weight gain and escalating insulin doses. This report underscores the need for further research into tailored, multifaceted therapeutic strategies for this growing patient population.
Indexed as
Identifiers
What OpenQuestion holds
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 OpenQuestion graph.