Add-on liraglutide may preserve insulin secretion in type 1 diabetes
medwireNews: Findings from the NewLira trial suggest that addition of the glucagon-like peptide (GLP)-1 receptor agonist liraglutide to insulin treatment may preserve postprandial insulin secretion among adults with newly diagnosed type 1 diabetes.
The study involved 63 adults aged an average of approximately 30 years with a diagnosis of type 1 diabetes in the past 6 weeks who were randomly assigned to receive liraglutide at a dose of 1.8 mg once daily or placebo in addition to insulin treatment. All participants had a BMI of at least 20 kg/m2 and postprandial C-peptide levels of at least 200 pmol/L following a liquid meal test.
After 1 year of treatment, postprandial glucose levels were significantly lower among the 31 patients given liraglutide compared with the 32 in the placebo arm, at approximately 3000 versus 3400 mmol/L.
And the primary outcome of area under the curve for C-peptide levels divided by area under the curve for the plasma glucose level at 1 year – an indicator of beta-cell function – was a significant 44% higher among patients treated with liraglutide versus placebo, at approximately 12,500 versus 7500 pmol/mmol over 240 minutes.
Presenting author Thomas Fremming Dejgaard (Steno Diabetes Center, Copenhagen, Denmark) noted, however, that there was no difference in beta-cell function between the groups 6 weeks after treatment with liraglutide or placebo was stopped.
In line with these findings, the total daily insulin dose required after 1 year of treatment was significantly lower among participants in the liraglutide group compared with those in the placebo group, at 18 IU and 32 IU, respectively. However, the presenter said that although significant between-group differences in the daily insulin dose were seen 4 weeks after commencing liraglutide treatment, the doses were comparable 6 weeks after the intervention ended.
The researchers also found significantly lower levels of the inflammatory markers interleukin-10 and tumor necrosis factor-alpha after 1 year of treatment with liraglutide versus placebo, but there were no significant changes in bodyweight or glycated hemoglobin levels over the treatment period.
Individuals treated with liraglutide were significantly less likely to experience mild hypoglycemia than those given placebo (1860 vs 2147 events over 58 weeks), and no episodes of severe hypoglycemia were reported.
Dejgaard said that other adverse events were “quite similar to what we know for patients treated with [GLP-1 receptor agonists].” The most commonly reported adverse event was nausea, affecting approximately 47% and 20% of participants in the liraglutide and placebo groups, respectively.
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