Liraglutide Examined for Efficacy in Type 1 Diabetes
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 study presented at the AACE 2017 Annual Meeting, liraglutide suppresses ghrelin, glucagon, lipolysis as well as ketogenesis, and, therefore, may be useful in the management of type 1 diabetes mellitus (T1DM).
The study authors explained that examining the effect of liraglutide on ketogenesis was important due to the “occurrence of diabetic ketoacidosis associated with the use of SGLT2 inhibitors in patients with T1DM and absence of this complication in patients treated with liraglutide in spite of reduction in insulin doses.”
To analyze this observation, 26 patients with uncontrolled T1DM treated with continuous subcutaneous insulin infusion (CSII) were randomly divided into two groups. Patients were administered 1.8mg of liraglutide or placebo after fasting overnight. The patients were then “maintained on their basal insulin infusion and were followed up for 5 hours.” Baseline HbA1c of the patients was reported as 7.7±0.3% and the average body mass index (BMI) of the patients was 31.8±1.8kg/m2.
Results of the study found that, although concentrations of glucose and glucagon were maintained, concentrations of free fatty acids (FFA), acetoacetate, b-hydroxybutyrate, and ghrelin were significantly increased from baseline in patients receiving placebo (P<0.05 for all). “In contrast, liraglutide significantly suppressed glucose (from 173±21 to 135±18mg/dL) and glucagon (from 91±15 to 72±13pg/mL) concentrations, reduced the increases in FFA (by 39±14%), and totally prevented the increase in ghrelin, acetoacetate and b-hydroxybutyrate concentrations,” reported the study authors. It was also noted that no significant change was seen in either group when measuring hormone sensitive lipase or lipoprotein lipase levels.
This study illustrates the effect that liraglutide has on ketogenesis in patients with uncontrolled T1DM. The authors state, “these observations are relevant to the use of liraglutide in the management of T1DM.”
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