Liraglutide as Additional Treatment to Insulin in Obese Patients with Type 1 Diabetes Mellitus |
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| Affiliation: | 1. Division of Endocrinology, Diabetes and Metabolism, State University of New York at Buffalo, and Kaleida Health;2. Division of Diabetes, Endocrinology & Metabolism, Rochester General Hospital, Rochester, New York,;3. Division of Pharmacy, St. John Fisher College, Rochester, New York.;1. Department of Surgery, Jersey Shore University Medical Center, Neptune, New Jersey;2. Department of Pathology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania;3. Department of Pathology, Jersey Shore University Medical Center, Neptune, New Jersey;4. Department of Endocrinology, Jersey Shore University Medical Center, Neptune, New Jersey;5. Shore Endocrinology Associates, Pt. Pleasant, New Jersey;6. Southern Ocean Medical Center, Manahawkin, New Jersey;7. Atlantic Hematology Oncology, Manasquan, New Jersey;8. Hereditary Cancer Risk Program, Meridian Health System, Neptune, New Jersey.;1. Section of Endocrine Surgery, UCLA David Geffen School of Medicine, Los Angeles, California.;2. Department of Pathology and Laboratory Medicine, UCLA David Geffen School of Medicine, Los Angeles, California.;1. Department of Endocrinology, the First People''s Hospital of Foshan, Foshan, Guangdong 52800, China;2. Southern Medical University, Guangzhou, Guangdong 510515, China;3. Department of Endocrinology, the Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong 510515, China;1. Department of Obstetrics and Gynecology, Herlev Gentofte Hospital, Herlev Ringvej 75, DK-2730 Herlev, Denmark;2. Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3, DK-2200 Copenhagen, Denmark;3. Department of Internal Medicine, Endocrine Unit, Herlev Gentofte Hospital, Herlev Ringvej 75, DK-2730 Herlev, Denmark |
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| Abstract: | ObjectiveBecause approximately 40% of patients with type 1 diabetes have the metabolic syndrome, we tested the hypothesis that addition of liraglutide to insulin in obese patients with type 1 diabetes will result in an improvement in plasma glucose concentrations, a reduction in hemoglobin A1c (HbA1c), a fall in systolic blood pressure, and weight loss.MethodsThis is a retrospective analysis of data obtained from 27 obese patients with type 1 diabetes treated with liraglutide in addition to insulin. Patients were also treated for hypertension. Paired t tests were used to compare the changes in HbA1c, insulin doses, body weight, body mass index, 4-week mean blood glucose concentrations (28-day insulin pump mean blood glucose), blood pressure, and lipid parameters prior to and 180 ± 14 days after liraglutide therapy.ResultsMean glucose concentrations fell from 191 ± 6 to 170 ± 6 mg/dL (P = .002). HbA1c fell from 7.89 ± 0.13% to 7.46 ± 0.13% (P = .001), without an increase in frequency of hypoglycemia. Mean body weight fell from 96.20 ± 3.68 kg to 91.56 ± 3.78 kg (P<.0001). Daily total and bolus doses of insulin fell from 73 ± 6 to 60 ± 4 (P = .008) units and from 40 ± 5 to 29 ± 3 units (P = .011), respectively. Mean systolic blood pressure fell from 130 ± 3 to 120 ± 4 mm Hg (P = .020).ConclusionAddition of liraglutide to insulin in obese patients with type 1 diabetes mellitus leads to improvements in glycemic control and HbA1c and to reductions in insulin dose, systolic blood pressure, and body weight. (Endocr Pract. 2013;19:963-967) |
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