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Effect of Liraglutide on Times in Glycaemic Ranges as Assessed by CGM for Type 2 Diabetes Patients Treated With Multiple Daily Insulin Injections

INTRODUCTION: The effects of the GLP-1 analogue liraglutide on time in hypoglycaemia, time in hyperglycaemia, and time in range for type 2 diabetes patients initially treated with multiple daily insulin injections (MDI) were investigated. Variables associated with hypoglycaemia in the current popula...

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Autores principales: Sofizadeh, Sheyda, Imberg, Henrik, Ólafsdóttir, Arndís F., Ekelund, Magnus, Dahlqvist, Sofia, Hirsch, Irl, Filipsson, Karin, Ahrén, Bo, Sjöberg, Stefan, Tuomilehto, Jaako, Lind, Marcus
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Healthcare 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6848584/
https://www.ncbi.nlm.nih.gov/pubmed/31564026
http://dx.doi.org/10.1007/s13300-019-00692-1
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author Sofizadeh, Sheyda
Imberg, Henrik
Ólafsdóttir, Arndís F.
Ekelund, Magnus
Dahlqvist, Sofia
Hirsch, Irl
Filipsson, Karin
Ahrén, Bo
Sjöberg, Stefan
Tuomilehto, Jaako
Lind, Marcus
author_facet Sofizadeh, Sheyda
Imberg, Henrik
Ólafsdóttir, Arndís F.
Ekelund, Magnus
Dahlqvist, Sofia
Hirsch, Irl
Filipsson, Karin
Ahrén, Bo
Sjöberg, Stefan
Tuomilehto, Jaako
Lind, Marcus
author_sort Sofizadeh, Sheyda
collection PubMed
description INTRODUCTION: The effects of the GLP-1 analogue liraglutide on time in hypoglycaemia, time in hyperglycaemia, and time in range for type 2 diabetes patients initially treated with multiple daily insulin injections (MDI) were investigated. Variables associated with hypoglycaemia in the current population were also identified. METHODS: Analyses were based on data from a previously performed double-blind, placebo-controlled trial in which 124 MDI-treated patients with type 2 diabetes were randomized to liraglutide or placebo. Masked continuous glucose monitoring (CGM) was performed at baseline and week 24 in 99 participants. RESULTS: The mean time in hypoglycaemia was similar for participants receiving liraglutide and those receiving placebo after 24 weeks of treatment. Mean time in target was greater in the liraglutide group than in the placebo group: 430 versus 244 min/24 h (p < 0.001) and 960 versus 695 min/24 h (p < 0.001) for the two glycaemic ranges considered, 4–7 mmol/l and 4–10 mmol/l, respectively. Mean time in hyperglycaemia was lower in the liraglutide group: 457 versus 723 min/24 h (p = 0.001) and 134 versus 264 min/24 h (p = 0.023) for the two cutoffs considered, > 10 mmol/l and > 14 mmol/l, respectively. Lower mean glucose level, lower C-peptide, and higher glucose variability were associated with an increased risk of hypoglycaemia in both treatment groups. Higher proinsulin level was associated with a lower risk of hypoglycaemia in the liraglutide group. CONCLUSION: For type 2 diabetes patients initially treated with MDI, introducing liraglutide had a beneficial effect on glucose profiles estimated by masked CGM. Mean glucose level, glycaemic variability, C-peptide, and proinsulin level influenced the risk of hypoglycaemia in this population. TRIAL REGISTRATION: ClinicalTrials.gov, number (EudraCT nr: 2012-001941-42). FUNDING: Novo Nordisk funded this study. The Diabetes Research Unit, NU-Hospital Group funded the journal’s Rapid Service Fee. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s13300-019-00692-1) contains supplementary material, which is available to authorized users.
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spelling pubmed-68485842019-11-22 Effect of Liraglutide on Times in Glycaemic Ranges as Assessed by CGM for Type 2 Diabetes Patients Treated With Multiple Daily Insulin Injections Sofizadeh, Sheyda Imberg, Henrik Ólafsdóttir, Arndís F. Ekelund, Magnus Dahlqvist, Sofia Hirsch, Irl Filipsson, Karin Ahrén, Bo Sjöberg, Stefan Tuomilehto, Jaako Lind, Marcus Diabetes Ther Original Research INTRODUCTION: The effects of the GLP-1 analogue liraglutide on time in hypoglycaemia, time in hyperglycaemia, and time in range for type 2 diabetes patients initially treated with multiple daily insulin injections (MDI) were investigated. Variables associated with hypoglycaemia in the current population were also identified. METHODS: Analyses were based on data from a previously performed double-blind, placebo-controlled trial in which 124 MDI-treated patients with type 2 diabetes were randomized to liraglutide or placebo. Masked continuous glucose monitoring (CGM) was performed at baseline and week 24 in 99 participants. RESULTS: The mean time in hypoglycaemia was similar for participants receiving liraglutide and those receiving placebo after 24 weeks of treatment. Mean time in target was greater in the liraglutide group than in the placebo group: 430 versus 244 min/24 h (p < 0.001) and 960 versus 695 min/24 h (p < 0.001) for the two glycaemic ranges considered, 4–7 mmol/l and 4–10 mmol/l, respectively. Mean time in hyperglycaemia was lower in the liraglutide group: 457 versus 723 min/24 h (p = 0.001) and 134 versus 264 min/24 h (p = 0.023) for the two cutoffs considered, > 10 mmol/l and > 14 mmol/l, respectively. Lower mean glucose level, lower C-peptide, and higher glucose variability were associated with an increased risk of hypoglycaemia in both treatment groups. Higher proinsulin level was associated with a lower risk of hypoglycaemia in the liraglutide group. CONCLUSION: For type 2 diabetes patients initially treated with MDI, introducing liraglutide had a beneficial effect on glucose profiles estimated by masked CGM. Mean glucose level, glycaemic variability, C-peptide, and proinsulin level influenced the risk of hypoglycaemia in this population. TRIAL REGISTRATION: ClinicalTrials.gov, number (EudraCT nr: 2012-001941-42). FUNDING: Novo Nordisk funded this study. The Diabetes Research Unit, NU-Hospital Group funded the journal’s Rapid Service Fee. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s13300-019-00692-1) contains supplementary material, which is available to authorized users. Springer Healthcare 2019-09-28 2019-12 /pmc/articles/PMC6848584/ /pubmed/31564026 http://dx.doi.org/10.1007/s13300-019-00692-1 Text en © The Author(s) 2019 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Research
Sofizadeh, Sheyda
Imberg, Henrik
Ólafsdóttir, Arndís F.
Ekelund, Magnus
Dahlqvist, Sofia
Hirsch, Irl
Filipsson, Karin
Ahrén, Bo
Sjöberg, Stefan
Tuomilehto, Jaako
Lind, Marcus
Effect of Liraglutide on Times in Glycaemic Ranges as Assessed by CGM for Type 2 Diabetes Patients Treated With Multiple Daily Insulin Injections
title Effect of Liraglutide on Times in Glycaemic Ranges as Assessed by CGM for Type 2 Diabetes Patients Treated With Multiple Daily Insulin Injections
title_full Effect of Liraglutide on Times in Glycaemic Ranges as Assessed by CGM for Type 2 Diabetes Patients Treated With Multiple Daily Insulin Injections
title_fullStr Effect of Liraglutide on Times in Glycaemic Ranges as Assessed by CGM for Type 2 Diabetes Patients Treated With Multiple Daily Insulin Injections
title_full_unstemmed Effect of Liraglutide on Times in Glycaemic Ranges as Assessed by CGM for Type 2 Diabetes Patients Treated With Multiple Daily Insulin Injections
title_short Effect of Liraglutide on Times in Glycaemic Ranges as Assessed by CGM for Type 2 Diabetes Patients Treated With Multiple Daily Insulin Injections
title_sort effect of liraglutide on times in glycaemic ranges as assessed by cgm for type 2 diabetes patients treated with multiple daily insulin injections
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6848584/
https://www.ncbi.nlm.nih.gov/pubmed/31564026
http://dx.doi.org/10.1007/s13300-019-00692-1
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