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Liraglutide as Add-On Therapy to Insulin in Type 2 Diabetes Mellitus: A Retrospective, Observational Study From a Daily Clinical Practice Setting in Switzerland

INTRODUCTION: In most patients with type 2 diabetes mellitus (T2DM) and progressive beta-cell insufficiency, insulin therapy is required to achieve sufficient glycemic control. However, insulin therapy may lead to weight gain and increasing risk of hypoglycemia. Glucagon-like peptide-1 receptor agon...

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Autores principales: Lipowsky, Christof, Sze, Lisa, Krull, Ina, Brändle, Michael
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Healthcare 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4374072/
https://www.ncbi.nlm.nih.gov/pubmed/25576400
http://dx.doi.org/10.1007/s13300-014-0093-8
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author Lipowsky, Christof
Sze, Lisa
Krull, Ina
Brändle, Michael
author_facet Lipowsky, Christof
Sze, Lisa
Krull, Ina
Brändle, Michael
author_sort Lipowsky, Christof
collection PubMed
description INTRODUCTION: In most patients with type 2 diabetes mellitus (T2DM) and progressive beta-cell insufficiency, insulin therapy is required to achieve sufficient glycemic control. However, insulin therapy may lead to weight gain and increasing risk of hypoglycemia. Glucagon-like peptide-1 receptor agonists are being used as add-on therapy to insulin with favorable metabolic effects. Nonetheless, to date only few studies exist reporting on the combination of liraglutide and insulin with a short follow-up period. The aim of this study was to evaluate the efficacy and safety of liraglutide as add-on to insulin in patients with T2DM over a time period of up to 24–28 months. METHODS: Data of patients with T2DM, treated with insulin and liraglutide at an outpatient clinic in a tertiary referral hospital from October 2009 until December 2011 were retrospectively examined (n = 36). Glycated hemoglobin (HbA1c), weight, total daily insulin dose and side effects were assessed 5–8 months prior to liraglutide, at baseline and at follow-up visits after 3, 6, 12–16 and 24–28 months. RESULTS: Median HbA1c decreased significantly from 7.7% [interquartile range (IQR) 7.0–8.6] at baseline to 6.8% (IQR 6.5–7.7, p = 0.001) at 3 months and 6.9% (IQR 6.3–7.6, p = 0.0001) at 6 months, but re-increased thereafter (at 24–28 months, median 7.5%, IQR 7.1–8.2, p = 1.0). Median weight decreased significantly from 99.8 kg (IQR 81–110) at baseline to 97.7 kg (IQR 81.2–108.2, p = 0.027) at 3 months, but rose again thereafter. Insulin dosage did not change significantly over time. No severe hypoglycemia or major side effects occurred. CONCLUSIONS: In this observational study, adding liraglutide to insulin in daily clinical practice reduced HbA1c significantly within 6 months, but there may be a non-sustainable effect during long-term treatment. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s13300-014-0093-8) contains supplementary material, which is available to authorized users.
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spelling pubmed-43740722015-03-30 Liraglutide as Add-On Therapy to Insulin in Type 2 Diabetes Mellitus: A Retrospective, Observational Study From a Daily Clinical Practice Setting in Switzerland Lipowsky, Christof Sze, Lisa Krull, Ina Brändle, Michael Diabetes Ther Original Research INTRODUCTION: In most patients with type 2 diabetes mellitus (T2DM) and progressive beta-cell insufficiency, insulin therapy is required to achieve sufficient glycemic control. However, insulin therapy may lead to weight gain and increasing risk of hypoglycemia. Glucagon-like peptide-1 receptor agonists are being used as add-on therapy to insulin with favorable metabolic effects. Nonetheless, to date only few studies exist reporting on the combination of liraglutide and insulin with a short follow-up period. The aim of this study was to evaluate the efficacy and safety of liraglutide as add-on to insulin in patients with T2DM over a time period of up to 24–28 months. METHODS: Data of patients with T2DM, treated with insulin and liraglutide at an outpatient clinic in a tertiary referral hospital from October 2009 until December 2011 were retrospectively examined (n = 36). Glycated hemoglobin (HbA1c), weight, total daily insulin dose and side effects were assessed 5–8 months prior to liraglutide, at baseline and at follow-up visits after 3, 6, 12–16 and 24–28 months. RESULTS: Median HbA1c decreased significantly from 7.7% [interquartile range (IQR) 7.0–8.6] at baseline to 6.8% (IQR 6.5–7.7, p = 0.001) at 3 months and 6.9% (IQR 6.3–7.6, p = 0.0001) at 6 months, but re-increased thereafter (at 24–28 months, median 7.5%, IQR 7.1–8.2, p = 1.0). Median weight decreased significantly from 99.8 kg (IQR 81–110) at baseline to 97.7 kg (IQR 81.2–108.2, p = 0.027) at 3 months, but rose again thereafter. Insulin dosage did not change significantly over time. No severe hypoglycemia or major side effects occurred. CONCLUSIONS: In this observational study, adding liraglutide to insulin in daily clinical practice reduced HbA1c significantly within 6 months, but there may be a non-sustainable effect during long-term treatment. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s13300-014-0093-8) contains supplementary material, which is available to authorized users. Springer Healthcare 2015-01-10 2015-03 /pmc/articles/PMC4374072/ /pubmed/25576400 http://dx.doi.org/10.1007/s13300-014-0093-8 Text en © The Author(s) 2015 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.
spellingShingle Original Research
Lipowsky, Christof
Sze, Lisa
Krull, Ina
Brändle, Michael
Liraglutide as Add-On Therapy to Insulin in Type 2 Diabetes Mellitus: A Retrospective, Observational Study From a Daily Clinical Practice Setting in Switzerland
title Liraglutide as Add-On Therapy to Insulin in Type 2 Diabetes Mellitus: A Retrospective, Observational Study From a Daily Clinical Practice Setting in Switzerland
title_full Liraglutide as Add-On Therapy to Insulin in Type 2 Diabetes Mellitus: A Retrospective, Observational Study From a Daily Clinical Practice Setting in Switzerland
title_fullStr Liraglutide as Add-On Therapy to Insulin in Type 2 Diabetes Mellitus: A Retrospective, Observational Study From a Daily Clinical Practice Setting in Switzerland
title_full_unstemmed Liraglutide as Add-On Therapy to Insulin in Type 2 Diabetes Mellitus: A Retrospective, Observational Study From a Daily Clinical Practice Setting in Switzerland
title_short Liraglutide as Add-On Therapy to Insulin in Type 2 Diabetes Mellitus: A Retrospective, Observational Study From a Daily Clinical Practice Setting in Switzerland
title_sort liraglutide as add-on therapy to insulin in type 2 diabetes mellitus: a retrospective, observational study from a daily clinical practice setting in switzerland
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4374072/
https://www.ncbi.nlm.nih.gov/pubmed/25576400
http://dx.doi.org/10.1007/s13300-014-0093-8
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