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Nasal GLP-1 compound shows promise in type 2 diabetes
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A nasal glucagon-like peptide-1 compound could be used to effectively treat type 2 diabetes, but future trials are still needed, according to findings from a Japanese study published in Diabetes Care.
In a prospective, randomized, double blind study, Hiroaki Ueno, MD, of the University of Miyazaki, and colleagues divided 26 patients with type 2 diabetes into groups to receive an intranasal powder formulation of GLP-1 (n=18) or placebo (n=8). Participants, aged 20 to 70 years, had inadequately controlled conditions through oral antidiabetic drugs. Age, sex, BMI and HbA1c levels did not differ significantly between groups.
The compound containing 1.2 mg of recombinant human GLP-1 or placebo was administered, using a spray device in the naval cavity, immediately before every meal for 2 weeks. Regimens of oral hypoglycemic agents were unchanged. Plasma glucagon levels were measured by radioimmunoassay. Plasma active GLP-1 levels were measured using blood sampling tubes.
The plasma peak concentration of active GLP-1 was 47.2 pmol/L, with Tmax of 8.1 minutes. In the GLP-1 group, early phase of insulin and glucagon secretion were recovered and suppressed, respectively. Glycoalbumin levels decreased significantly and 1,5-anhydroglucitol levels increased significantly after GLP-1 administration. No marked adverse events were seen with nasal GLP-1.
“Intranasal administration of active GLP-1 resulted in rapid peripheral appearance and disappearance of active GLP-1 in diabetic patients,” the researchers wrote. “GLP-1 induced early-phase insulin secretion, inhibition of inappropriate glucagon secretion, and improvement in intermediate-term markers of glycemic control without severe adverse events.”
Compared with subcutaneous injections, the relative ease of intranasal administration may seem more acceptable. The researchers said, however, that the relative frequency required could lead to decreased adherence.
Disclosure: This study was supported by the Practical Application for the Japan Science and Technology Agency. Asubio Pharma Co., Ltd. provided the drug and helped in conducting the trial.
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