Cargando…

Prediction of response to GLP-1 receptor agonist therapy in Japanese patients with type 2 diabetes

BACKGROUND: Glucagon-like peptide-1 (GLP-1) receptor agonists can maintain good glycemic control in some diabetic. Here we compared the clinical characteristics and parameters reflecting glucose metabolism at the time of the initiation of GLP-1 receptor agonist therapy between patients who responded...

Descripción completa

Detalles Bibliográficos
Autores principales: Imai, Kenjiro, Tsujimoto, Tetsuro, Goto, Atsushi, Goto, Maki, Kishimoto, Miyako, Yamamoto-Honda, Ritsuko, Noto, Hiroshi, Kajio, Hiroshi, Noda, Mitsuhiko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4209043/
https://www.ncbi.nlm.nih.gov/pubmed/25349635
http://dx.doi.org/10.1186/1758-5996-6-110
_version_ 1782341211174993920
author Imai, Kenjiro
Tsujimoto, Tetsuro
Goto, Atsushi
Goto, Maki
Kishimoto, Miyako
Yamamoto-Honda, Ritsuko
Noto, Hiroshi
Kajio, Hiroshi
Noda, Mitsuhiko
author_facet Imai, Kenjiro
Tsujimoto, Tetsuro
Goto, Atsushi
Goto, Maki
Kishimoto, Miyako
Yamamoto-Honda, Ritsuko
Noto, Hiroshi
Kajio, Hiroshi
Noda, Mitsuhiko
author_sort Imai, Kenjiro
collection PubMed
description BACKGROUND: Glucagon-like peptide-1 (GLP-1) receptor agonists can maintain good glycemic control in some diabetic. Here we compared the clinical characteristics and parameters reflecting glucose metabolism at the time of the initiation of GLP-1 receptor agonist therapy between patients who responded well to therapy and those who did not. METHODS: The records of 43 patients with type 2 diabetes who started receiving GLP-1 receptor agonist therapy during hospitalization were retrospectively reviewed. Glucagon stimulation tests were performed, and patients were started on liraglutide or exenatide therapy. Preprandial blood glucose levels were measured on days 2 and 3 of GLP-1 receptor agonist therapy. We used the Cox proportional hazard model to compare clinical parameters between responders (HbA1c level <8% at more than 3 months after the initiation of treatment) and non-responders (HbA1c level ≥8% at more than 3 months after the initiation of treatment or a switch to insulin therapy at any time). RESULTS: Twenty-six of the 43 patients were classified as non-responders. At baseline, mean HbA1c levels were 9.9% among responders and 9.7% among non-responders. Compared with treatment with only diet or metformin, the hazard ratio [HR] for non-response was 5.3 (95% confidence interval [CI]: 1.16-24.6, P = 0.03) for insulin therapy and 5.0 (95% CI: 1.13-22.16, P = 0.03) for sulfonylurea therapy. Compared with the lowest tertile, the HRs for non-response in the highest tertile were 3.1 (95% CI: 1.04-8.97, P = 0.04) for the mean preprandial blood glucose level on days 2 and 3 and 3.4 (95% CI: 1.05-11.01, P = 0.04) for the body mass index. The response was not significantly associated with the duration of diabetes or the glucagon stimulation test results. A receiver operating curve analysis showed that the mean preprandial blood glucose level had the highest area under the curve value (=0.72) for the prediction of non-responders. CONCLUSIONS: In patients with poorly controlled diabetes, the response to GLP-1 receptor agonist therapy was significantly associated with the treatment used before the initiation of therapy, the body mass index, and the mean preprandial blood glucose level during the 2 days after the initiation of therapy.
format Online
Article
Text
id pubmed-4209043
institution National Center for Biotechnology Information
language English
publishDate 2014
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-42090432014-10-28 Prediction of response to GLP-1 receptor agonist therapy in Japanese patients with type 2 diabetes Imai, Kenjiro Tsujimoto, Tetsuro Goto, Atsushi Goto, Maki Kishimoto, Miyako Yamamoto-Honda, Ritsuko Noto, Hiroshi Kajio, Hiroshi Noda, Mitsuhiko Diabetol Metab Syndr Research BACKGROUND: Glucagon-like peptide-1 (GLP-1) receptor agonists can maintain good glycemic control in some diabetic. Here we compared the clinical characteristics and parameters reflecting glucose metabolism at the time of the initiation of GLP-1 receptor agonist therapy between patients who responded well to therapy and those who did not. METHODS: The records of 43 patients with type 2 diabetes who started receiving GLP-1 receptor agonist therapy during hospitalization were retrospectively reviewed. Glucagon stimulation tests were performed, and patients were started on liraglutide or exenatide therapy. Preprandial blood glucose levels were measured on days 2 and 3 of GLP-1 receptor agonist therapy. We used the Cox proportional hazard model to compare clinical parameters between responders (HbA1c level <8% at more than 3 months after the initiation of treatment) and non-responders (HbA1c level ≥8% at more than 3 months after the initiation of treatment or a switch to insulin therapy at any time). RESULTS: Twenty-six of the 43 patients were classified as non-responders. At baseline, mean HbA1c levels were 9.9% among responders and 9.7% among non-responders. Compared with treatment with only diet or metformin, the hazard ratio [HR] for non-response was 5.3 (95% confidence interval [CI]: 1.16-24.6, P = 0.03) for insulin therapy and 5.0 (95% CI: 1.13-22.16, P = 0.03) for sulfonylurea therapy. Compared with the lowest tertile, the HRs for non-response in the highest tertile were 3.1 (95% CI: 1.04-8.97, P = 0.04) for the mean preprandial blood glucose level on days 2 and 3 and 3.4 (95% CI: 1.05-11.01, P = 0.04) for the body mass index. The response was not significantly associated with the duration of diabetes or the glucagon stimulation test results. A receiver operating curve analysis showed that the mean preprandial blood glucose level had the highest area under the curve value (=0.72) for the prediction of non-responders. CONCLUSIONS: In patients with poorly controlled diabetes, the response to GLP-1 receptor agonist therapy was significantly associated with the treatment used before the initiation of therapy, the body mass index, and the mean preprandial blood glucose level during the 2 days after the initiation of therapy. BioMed Central 2014-10-15 /pmc/articles/PMC4209043/ /pubmed/25349635 http://dx.doi.org/10.1186/1758-5996-6-110 Text en © Imai et al.; licensee BioMed Central Ltd. 2014 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Imai, Kenjiro
Tsujimoto, Tetsuro
Goto, Atsushi
Goto, Maki
Kishimoto, Miyako
Yamamoto-Honda, Ritsuko
Noto, Hiroshi
Kajio, Hiroshi
Noda, Mitsuhiko
Prediction of response to GLP-1 receptor agonist therapy in Japanese patients with type 2 diabetes
title Prediction of response to GLP-1 receptor agonist therapy in Japanese patients with type 2 diabetes
title_full Prediction of response to GLP-1 receptor agonist therapy in Japanese patients with type 2 diabetes
title_fullStr Prediction of response to GLP-1 receptor agonist therapy in Japanese patients with type 2 diabetes
title_full_unstemmed Prediction of response to GLP-1 receptor agonist therapy in Japanese patients with type 2 diabetes
title_short Prediction of response to GLP-1 receptor agonist therapy in Japanese patients with type 2 diabetes
title_sort prediction of response to glp-1 receptor agonist therapy in japanese patients with type 2 diabetes
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4209043/
https://www.ncbi.nlm.nih.gov/pubmed/25349635
http://dx.doi.org/10.1186/1758-5996-6-110
work_keys_str_mv AT imaikenjiro predictionofresponsetoglp1receptoragonisttherapyinjapanesepatientswithtype2diabetes
AT tsujimototetsuro predictionofresponsetoglp1receptoragonisttherapyinjapanesepatientswithtype2diabetes
AT gotoatsushi predictionofresponsetoglp1receptoragonisttherapyinjapanesepatientswithtype2diabetes
AT gotomaki predictionofresponsetoglp1receptoragonisttherapyinjapanesepatientswithtype2diabetes
AT kishimotomiyako predictionofresponsetoglp1receptoragonisttherapyinjapanesepatientswithtype2diabetes
AT yamamotohondaritsuko predictionofresponsetoglp1receptoragonisttherapyinjapanesepatientswithtype2diabetes
AT notohiroshi predictionofresponsetoglp1receptoragonisttherapyinjapanesepatientswithtype2diabetes
AT kajiohiroshi predictionofresponsetoglp1receptoragonisttherapyinjapanesepatientswithtype2diabetes
AT nodamitsuhiko predictionofresponsetoglp1receptoragonisttherapyinjapanesepatientswithtype2diabetes