Evaluating the Impact of Glucagon-Like Peptide-1 Receptor Agonists on Metabolic Changes in Patients With Type 2 Diabetes on High-Dose Insulin.

BACKGROUND

Studies involving the glucagon-like peptide-1 receptor agonist (GLP-1 RA) liraglutide have shown reductions in hemoglobin A1c (HbA1c), weight, and insulin requirements in patients with type 2 diabetes mellitus (DM2) requiring high-dose insulin therapy. The effect of the class of GLP-1 RAs on these parameters is unknown.

DATA SOURCES

A retrospective cohort analysis was conducted in patients with DM2 where a GLP-1 RA was added to high-dose insulin therapy. The primary composite outcome was the change from baseline to 9 months in HbA1c, weight, and insulin dose.

RESULTS

GLP-1 RA therapy was associated with a significant reduction in HbA1c from baseline (-0.9%; P = 0.022). Weight and insulin dose were not significantly reduced from baseline. There was a moderate effect of individual agents on these outcomes, but no significant reductions were seen due to the small sample size.

LIMITATIONS

Generalizability of these findings may be limited by the characteristics and size of the study population.

THERAPEUTIC OPINION

The effect of GLP-1 RA therapy on HbA1c may be attributed to the medication class. The effect of individual agents on weight and insulin requirements needs further investigation.