Novo Nordisk announced that Xultophy® (insulin degludec + liraglutide injection), a once-daily, fixed-ratio combination treatment in a pre-filled pen, is now available across Canada for the treatment of type 2 diabetes mellitus. Xultophy® was approved by Health Canada in April 2018. Xultophy® is indicated in Canada as an adjunct to lifestyle modifications for the once-daily treatment of adults with type 2 diabetes mellitus to improve glycemic control in combination with metformin, with or without sulfonylurea, when these combined with basal insulin (less than 50 units daily) or liraglutide (less than or equal to 1.8 mg daily), do not provide adequate glycemic control.4 Xultophy® can be taken independent of meals, at any time of day, preferably at the same time of the day. The approval of Xultophy® was based on efficacy and safety data from the DUAL™ (Dual Action of Liraglutide and Insulin Degludec in Type 2 Diabetes) clinical development program. In three DUAL™ trials involving 1,393 randomized adults with type 2 diabetes, patients who were inadequately controlled on liraglutide or insulin glargine and switched to Xultophy® achieved significant reductions in HbA1c. For adults inadequately controlled on insulin glargine and insulin degludec, Xultophy® demonstrated clinically significant greater HbA1c level reductions from baseline (-1.83% for the Xultophy® group vs -1.22% for the insulin glargine group and -1.96% for the Xultophy® group vs -0.97% for the insulin degludec group). The most frequently reported adverse reactions during treatment with Xultophy® were hypoglycemia and gastrointestinal adverse reactions, of which nausea was the most frequently reported and declined as treatment continued.