Premium
The effect of addition of liraglutide to high‐dose intensive insulin therapy: a randomized prospective trial
Author(s) -
Lane W.,
Weinrib S.,
Rappaport J.,
Hale C.
Publication year - 2014
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.12286
Subject(s) - insulin , liraglutide , medicine , endocrinology , diabetes mellitus , type 2 diabetes , bolus (digestion)
Aims Patients with type 2 diabetes and insulin resistance may require high insulin doses to control hyperglycaemia. The addition of glucagon‐like peptide‐1 receptor agonists ( GLP ‐1 RA s) to basal insulin therapy has been shown to reduce insulin requirement while reducing insulin‐associated weight gain [1,2]. The effect of GLP ‐1 RA therapy added to intensive (basal/bolus) insulin therapy has not been studied in a prospective trial. This trial evaluated the effect of the addition of liraglutide to high‐dose intensive insulin therapy compared with standard insulin up‐titration in obese insulin‐resistant patients with type 2 diabetes requiring high‐dose insulin therapy. Methods Thirty‐seven subjects with type 2 diabetes requiring >100 units of insulin daily administered either by continuous subcutaneous insulin infusion ( CSII ) or by multiple daily injections ( MDIs ) with or without metformin were randomized to receive either liraglutide plus insulin (LIRA) or intensive insulin only (controls). Liraglutide was initiated at 0.6 mg subcutaneously (sq) per day and increased to either 1.2 or 1.8 mg daily in combination with intensive insulin therapy. Controls received intensive insulin up‐titration only. Results At 6 months, subjects receiving liraglutide plus insulin experienced statistically significant reductions in HbA1c , weight, insulin dose and glycaemic variability (GV) by continuous glucose monitor ( CGM ) compared with the control group receiving insulin only. Conclusions Adding liraglutide to intensive high‐dose (basal/bolus) insulin therapy results in greater improvement in glycaemic control than insulin therapy alone, with additional benefits of weight loss and reduced GV.