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Liraglutide as adjunct to insulin reduces HbA1c, BMI

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ORLANDO, Fla. — Patients with type 1 diabetes treated with liraglutide as an adjunct to insulin had significantly reduced HbA1c and BMI, according to findings presented here.

“Insulin is essential for patients with type 1 diabetes,” the researchers wrote. “With the obesity epidemic, obesity and insulin resistance are no longer uncommon features in these patients. This has led to increased interest in the role of glucagon-like receptor agonists as adjunctive therapy in this patient population.”

In the cross-sectional, retrospective study, Irl B. Hirsch, MD, professor of medicine at the University of Washington in Seattle, and colleagues evaluated 31 adults (mean age, 44.6 years) with type 1 diabetes prescribed liraglutide from January 2014 to January 2015 to determine the indications for use, efficacy and adverse events of liraglutide as an adjunct to insulin. Researchers compared baseline HbA1c and BMI with a follow-up visit and the most recent visit. A control group was created by recording HbA1c and BMI about 3 to 6 months before initiation of liraglutide.

Irl B. Hirsch

Baseline HbA1c was 7.9% and BMI was 32.6 kg/m². There was no change in HbA1c from before initiation of liraglutide to baseline; however, HbA1c was significantly decreased from baseline at 3.7 months (P = .001). The effect remained at the most recent visit (33.9 months) with a decrease of 1.07% (P = .009).

No difference was found between baseline BMI and pretreatment BMI; however, it decreased by 0.4 kg/m² from baseline to follow-up (P < .001) and by 0.03 kg/m² from baseline to the most recent visit (P = .04).

The most common reason for initiation of liraglutide was insulin resistance (29%) followed by poor control (25.8%), weight loss (22.6%), unclear reason (12.9%) and preservation of pancreatic beta-cell function.

Hypoglycemia and gastrointestinal adverse events were common, but there were no events of severe hypoglycemia.

“This study reports short-term and long-term HbA1c and BMI benefit despite recent larger randomized trials that did not,” Hirsch and colleagues wrote. “This may be due in part to the higher BMI observed in our cohort. Liraglutide does appear to be a beneficial adjunct, but it remains unclear which patients are the best candidates for this treatment.” – by Amber Cox

Reference:

Batacchi Z, et al. Abstract 215. Presented at: AACE Annual Scientific and Clinical Congress; May 25-29, 2016; Orlando, Fla.

Disclosure: Hirsch reports receiving honoraria from Abbott, Becton Dickinson and Roche, and research grants from Novo Nordisk.