Efficacy and Safety of Liraglutide Added to Insulin Therapy in Elderly Patients with Type 2 Diabetes

Overview

Journal Endocrinol Diabetes Metab

Specialty Endocrinology

Date 2019 Mar 1

PMID 30815572

Citations 3

Authors

Mie Tonoike

Daisuke Chujo

Mitsuhiko Noda

Affiliations

Soon will be listed here.

Abstract

Introduction: The combination of GLP-1 receptor agonists and insulin is effective in type 2 diabetes (T2D) treatment. However, its longitudinal efficacy and safety in elderly patients have not been established. We evaluated whether liraglutide (Lira) added to insulin therapy safely improved glycaemic control in T2D patients aged >65 years.

Methods: Twenty T2D patients receiving insulin were recruited, and Lira was added to their treatment regimen. Before and 6 months after Lira was added, we assessed the metabolic parameters and continuous glucose monitoring (CGM) data.

Results: Six months after Lira was added, the levels of HbA1c and glycated albumin and body weight were significantly improved, despite the daily doses and number of insulin injections per day being reduced. CGM analysis revealed that the SD and AUC of glucose >180 mg/dL were significantly decreased; the proportion of hypoglycaemic events was not increased.

Conclusion: Lira administration safely improved glycaemic control and reduced body weight. Lira added to insulin therapy may improve the quality of life in elderly T2D patients undergoing insulin therapy, especially those requiring social support.

Citing Articles

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Clinical and psychological characteristics of liraglutide treatment among patients with type 2 diabetes.

Al Hayek A, Al Dawish M J Family Med Prim Care. 2020; 9(2):1065-1071.

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Efficacy and safety of liraglutide added to insulin therapy in elderly patients with type 2 diabetes.

Tonoike M, Chujo D, Noda M Endocrinol Diabetes Metab. 2019; 2(1):e00043.

PMID: 30815572 PMC: 6354751. DOI: 10.1002/edm2.43.

References

Lind M, Hirsch I, Tuomilehto J, Dahlqvist S, Ahren B, Torffvit O . Liraglutide in people treated for type 2 diabetes with multiple daily insulin injections: randomised clinical trial (MDI Liraglutide trial). BMJ. 2015; 351:h5364. PMC: 4624838. DOI: 10.1136/bmj.h5364. View

Pontiroli A, Miele L, Morabito A . Increase of body weight during the first year of intensive insulin treatment in type 2 diabetes: systematic review and meta-analysis. Diabetes Obes Metab. 2011; 13(11):1008-19. DOI: 10.1111/j.1463-1326.2011.01433.x. View

Davies M, Bain S, Atkin S, Rossing P, Scott D, Shamkhalova M . Efficacy and Safety of Liraglutide Versus Placebo as Add-on to Glucose-Lowering Therapy in Patients With Type 2 Diabetes and Moderate Renal Impairment (LIRA-RENAL): A Randomized Clinical Trial. Diabetes Care. 2015; 39(2):222-30. DOI: 10.2337/dc14-2883. View

Halawi H, Khemani D, Eckert D, ONeill J, Kadouh H, Grothe K . Effects of liraglutide on weight, satiation, and gastric functions in obesity: a randomised, placebo-controlled pilot trial. Lancet Gastroenterol Hepatol. 2017; 2(12):890-899. DOI: 10.1016/S2468-1253(17)30285-6. View

Goldenberg R, Berard L . Adding prandial GLP-1 receptor agonists to basal insulin: a promising option for type 2 diabetes therapy. Curr Med Res Opin. 2017; 34(1):1-10. DOI: 10.1080/03007995.2017.1372118. View

Lin C, Li C, Hsiao C, Liu C, Yang S, Lee C . Time trend analysis of the prevalence and incidence of diagnosed type 2 diabetes among adults in Taiwan from 2000 to 2007: a population-based study. BMC Public Health. 2013; 13:318. PMC: 3626657. DOI: 10.1186/1471-2458-13-318. View

Tonoike M, Chujo D, Noda M . Efficacy and safety of liraglutide added to insulin therapy in elderly patients with type 2 diabetes. Endocrinol Diabetes Metab. 2019; 2(1):e00043. PMC: 6354751. DOI: 10.1002/edm2.43. View

Santilli F, Simeone P, Guagnano M, Leo M, Maccarone M, Di Castelnuovo A . Effects of Liraglutide on Weight Loss, Fat Distribution, and β-Cell Function in Obese Subjects With Prediabetes or Early Type 2 Diabetes. Diabetes Care. 2017; 40(11):1556-1564. DOI: 10.2337/dc17-0589. View

. 11. Older Adults: . Diabetes Care. 2017; 41(Suppl 1):S119-S125. DOI: 10.2337/dc18-S011. View

10.

Ligthelm R, Kaiser M, Vora J, Yale J . Insulin use in elderly adults: risk of hypoglycemia and strategies for care. J Am Geriatr Soc. 2012; 60(8):1564-70. DOI: 10.1111/j.1532-5415.2012.04055.x. View

11.

Blonde L, Russell-Jones D . The safety and efficacy of liraglutide with or without oral antidiabetic drug therapy in type 2 diabetes: an overview of the LEAD 1-5 studies. Diabetes Obes Metab. 2009; 11 Suppl 3:26-34. DOI: 10.1111/j.1463-1326.2009.01075.x. View

12.

Dahlqvist S, Ahlen E, Filipsson K, Gustafsson T, Hirsch I, Tuomilehto J . Variables associated with HbA1c and weight reductions when adding liraglutide to multiple daily insulin injections in persons with type 2 diabetes (MDI Liraglutide trial 3). BMJ Open Diabetes Res Care. 2018; 6(1):e000464. PMC: 5841497. DOI: 10.1136/bmjdrc-2017-000464. View

13.

Zhang X, Decker F, Luo H, Geiss L, Pearson W, Saaddine J . Trends in the prevalence and comorbidities of diabetes mellitus in nursing home residents in the United States: 1995-2004. J Am Geriatr Soc. 2010; 58(4):724-30. DOI: 10.1111/j.1532-5415.2010.02786.x. View

14.

Chittleborough C, Grant J, Phillips P, Taylor A . The increasing prevalence of diabetes in South Australia: the relationship with population ageing and obesity. Public Health. 2006; 121(2):92-9. DOI: 10.1016/j.puhe.2006.09.017. View

15.

Lane W, Weinrib S, Rappaport J, Hale C . The effect of addition of liraglutide to high-dose intensive insulin therapy: a randomized prospective trial. Diabetes Obes Metab. 2014; 16(9):827-32. DOI: 10.1111/dom.12286. View

16.

Eng C, Kramer C, Zinman B, Retnakaran R . Glucagon-like peptide-1 receptor agonist and basal insulin combination treatment for the management of type 2 diabetes: a systematic review and meta-analysis. Lancet. 2014; 384(9961):2228-34. DOI: 10.1016/S0140-6736(14)61335-0. View

17.

Ahren B . Insulin plus incretin: A glucose-lowering strategy for type 2-diabetes. World J Diabetes. 2014; 5(1):40-51. PMC: 3932426. DOI: 10.4239/wjd.v5.i1.40. View

18.

Marso S, Daniels G, Brown-Frandsen K, Kristensen P, Mann J, Nauck M . Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med. 2016; 375(4):311-22. PMC: 4985288. DOI: 10.1056/NEJMoa1603827. View

19.

Carver C . Insulin treatment and the problem of weight gain in type 2 diabetes. Diabetes Educ. 2006; 32(6):910-7. DOI: 10.1177/0145721706294259. View

20.

Sloan F, Bethel M, Ruiz Jr D, Shea A, Shea A, Feinglos M . The growing burden of diabetes mellitus in the US elderly population. Arch Intern Med. 2008; 168(2):192-9. DOI: 10.1001/archinternmed.2007.35. View