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Liraglutide yields weight reduction but not HbA1c control in type 1 diabetes
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In normal weight patients with type 1 diabetes that is insufficiently controlled by insulin alone, the use of liraglutide as an add-on treatment significantly decreases body weight and insulin needs but does not appear to confer additional HbA1c benefits, according to recent findings.
In the randomized, double blind, placebo-controlled study, Christian S. Frandsen, of the University of Copenhagen, and colleagues evaluated 40 normal weight adults aged 18 to 70 years with poorly controlled type 1 diabetes (HbA1c, 8%). Participants were randomly allocated 1:1 to undergo once-daily treatment with liraglutide 1.2 mg or placebo for 12 weeks; 18 in each group completed the trial.
Participants were assessed with continuous glucose monitoring prior to and at the conclusion of treatment. At baseline, HbA1c was comparable between the two groups (8.8% in the liraglutide group vs. 8.7% in the placebo group). The study’s primary outcome was change in HbA1c from baseline to the conclusion of treatment, and the following were defined as secondary outcomes: change in insulin dose, weight, glycemic fluctuations, heart rate and blood pressure.
The researchers found that at 12 weeks, HbA1c decreased from baseline by -0.6% in the liraglutide group compared with -0.5% in the placebo group (P = .62, for comparison between groups).
Differences in glycemic excursions were not altered in either group.
In the liraglutide group, body weight decreased with a change after 12 weeks of -3.13 kg; conversely, body weight increased in the placebo group with a changes of 1.12 kg (P < .0001).
At week 12, there was a significant decrease in bolus insulin in the liraglutide group from 27.4 IU/day to 23.6 IU/day (P = .006). There was no change in bolus insulin dosage in the placebo group.
Although an increase in heart rate was seen within the liraglutide group from baseline (P = .04), it was not increased compared with placebo. However, the liraglutide group also demonstrated a decrease in mean systolic BP compared with placebo (P = .04).
Gastrointestinal side effects were more prevalent in the liraglutide group, while there was no difference between groups for the incidence of hypoglycemia.
“In conclusion, liraglutide 1.2 mg once daily as an add-on to insulin treatment in normal-weight, poorly controlled patients with type 1 diabetes, without endogenous insulin secretion, has no significant effect on HbA1c, a minor but significant effect on the dose of bolus insulin, and induces a significant reduction in body weight with an incidence of hypoglycemia similar to placebo,” the researchers wrote. – by Jennifer Byrne
Disclosure: Frandsen reports financial ties with Novo Nordisk. Please see the full study for a list of all other authors’ relevant financial disclosures.
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