Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Effects of Liraglutide on Glycemic Control

Studying patients with T2D and multiple injections

Publish date:: November 17, 2015

Patients with type 2 diabetes can benefit from adding liraglutide to their multiple daily insulin injections through improved glycemic control without an increased risk of hypoglycemia, reduction in body weight, and the ability to lower insulin doses, according to a study of 124 participants who were randomized 1:1 to subcutaneous liraglutide or placebo. Researchers found:

• Liraglutide was associated with a significant reduction in HbA1c vs placebo (1.5% vs 0.4%, respectively).

• Body weight was significantly reduced in patients in the liraglutide group vs the placebo group and total daily inulin doses were also significantly reduced.

• Glycemic variability was reduced in patients treated with liraglutide.

Citation: Lind M, Hirsch IB, Tuomilehto J, et al. Liraglutide in people treated for type 2 diabetes with multiple daily insulin injections: randomized clinical trial (MDI Liraglutide trial). BMJ. 2015;351:h5364. doi:10.1136/bmj.h5364.

Commentary: This study adds to the evidence base that the GLP-1 class of diabetes medication, of which liraglutide is one, are potent glucose lowering medications that work well in addition to either basal or prandial insulin. Numerous studies have shown GLP-1s to provide improvement in glucose control when added to basal insulin.¹ This study shows liraglutide to provide improvement in glucose control when added to prandial insulin, and to have the additional benefit of weight loss. —Neil Skolnik, MD

1.) Rosenstock J, Fonseca VA, Gross JL, et al. Advancing basal insulin replacement in type 2 diabetes inadequately controlled with insulin glargine plus oral agents: a comparison of adding albiglutide, a weekly GLP-1 receptor agonist, versus thrice-daily prandial insulin lispro. Diabetes Care 2014;37(8):2317-2325. doi:10.2337/dc14-0001.

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