Complete Remission Seen With GLP-1 Agonist Therapy in T2DM Patients
This article is written live from the American Association of Clinical Endocrinologists (AACE) 2017 Annual Meeting in Austin, TX. MPR will be reporting news on the latest findings from leading experts in endocrinology. Check back for more news from AACE 2017.
According to results of a retrospective analysis presented at the AACE 2017 Annual Meeting, liraglutide (LIRA) not only significantly improved glycemic parameters but also reduced body weight (BW), body mass index (BMI), and waist circumference (WC) in patients with new onset type 2 diabetes mellitus (T2DM).
The study authors hypothesized that because of its mechanism of action, LIRA “could address the multiple etiopathogeneses of T2DM,” and therefore, “should bring complete remission of T2DM in newly diagnosed patients.” To test their hypothesis, the authors utilized electronic medical records to identify patients with new onset T2DM (duration of disease of <1 year) that were taking LIRA and metformin with or without insulin. Of note, patients lost to follow-up or those that discontinued LIRA were not included in the analysis.
A total of 71 patients with new onset T2DM were identified. At baseline, patients in the study had an average HbA1c of 8.27±2.5%, an average fasting blood sugar (FBS) of 155.8±57.0mg/dL, and an average post-prandial blood sugar (PPBS) of 179.4±85.81mg/dL. Additionally, the authors reported that the patients had an average BMI of 30.5±4.0kg/m2, an average BW of 86.34±13.36kg, and an average WC of 104.2±12.32cm.
Treatment with LIRA significantly improved all clinical parameters tested for patients with new onset T2DM. After 6 months of therapy, clinical parameters reported were as follows: HbA1c of 5.96±0.35% (P<0.0001), FBS of 105.5±13.73mg/dL (P=0.0001), and PPBS of 105.0±20.20mg/dL (P=0.0003). The retrospective analysis also found that BMI was reduced to 28.99±3.85kg/m2 (P<0.0001), BW to 81.82±12.34kg (P<0.0001), and WC to 98.08±8.94cm (P=0.0017).
The authors also reported that, “at 2 years, LIRA therapy resulted in complete remission of diabetes in 74% of subjects, requiring no medications for the treatment of diabetes.” LIRA plus metformin with or without insulin in these patients given as telemedicine integrated protocol with discontinuation over 6-8 months led to complete remission in a significant proportion of patients, the authors concluded.
This retrospective analysis demonstrated that treatment with LIRA in patients with new onset T2DM is beneficial as it significantly improves clinical parameters and can lead to weight loss. The authors added, “this observation calls for randomized controlled trials [RCTs] in a wider population which will have a significant impact as a cost effective option for treating new onset diabetes.”
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