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

Am J Ther. 2022 Nov-Dec;29(6):e632-e636. doi: 10.1097/MJT.0000000000001283. Epub 2020 Dec 29.

Abstract

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.

MeSH terms

  • Blood Glucose / analysis
  • Diabetes Mellitus, Type 2* / chemically induced
  • Diabetes Mellitus, Type 2* / drug therapy
  • Glucagon-Like Peptide 1 / therapeutic use
  • Glucagon-Like Peptide-1 Receptor / therapeutic use
  • Glucagon-Like Peptide-1 Receptor Agonists
  • Glycated Hemoglobin
  • Humans
  • Hypoglycemic Agents / pharmacology
  • Hypoglycemic Agents / therapeutic use
  • Insulin*
  • Insulin, Regular, Human
  • Retrospective Studies

Substances

  • Insulin
  • Hypoglycemic Agents
  • Glucagon-Like Peptide-1 Receptor
  • Glycated Hemoglobin
  • Glucagon-Like Peptide 1
  • Insulin, Regular, Human
  • Blood Glucose
  • Glucagon-Like Peptide-1 Receptor Agonists