Open AccessDefining criteria for the introduction of liraglutide using the glucagon stimulation test in patients with type 2 diabetes
Author(s) -
Kondo Yoshinobu,
Satoh Shinobu,
Nagakura Joe,
Kimura Masayo,
Nezu Uru,
Terauchi Yasuo
Publication year - 2013
Publication title -
journal of diabetes investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.089
H-Index - 50
eISSN - 2040-1124
pISSN - 2040-1116
DOI - 10.1111/jdi.12082
Subject(s) - liraglutide , medicine , glycated hemoglobin , glucagon like peptide 1 , type 2 diabetes , diabetes mellitus , endocrinology , glucagon , glycemic , c peptide , insulin
Aims/Introduction To define a set of criteria using indices of β‐cell function, including results from the glucagon stimulation test, for liraglutide introduction in patients with type 2 diabetes. Materials and Methods In the present retrospective cohort study, patients were included in our analysis if their β‐cell function had been evaluated with a glucagon stimulation test and a 24‐h urinary C ‐peptide ( U ‐ CPR ) excretion test before switching from insulin therapy to liraglutide monotherapy. The efficacy of liraglutide was determined by the extent to which glycemic control was achieved or if glycated hemoglobin levels were maintained at <7.0% after liraglutide monotherapy for 24 weeks. Results Liraglutide was effective in 36 of 77 patients. In the liraglutide‐effective cases, the following parameters were higher: fasting C ‐peptide ( CPR 0) levels, C ‐peptide levels 6 min after glucagon stimulation ( CPR 6), the C ‐peptide index ( CPI ; CPR 0 × 100/fasting plasma glucose) and stimulated C ‐peptide index (S‐ CPI ; CPR 6 × 100/plasma glucose 6 min after glucagon stimulation). U ‐ CPR did not differ between liraglutide‐effective and liraglutide‐ineffective cases. Using receiver operating characteristic analysis adjusted for baseline characteristics, the independent cut‐off value for effective liraglutide introduction was 0.72 for CPI and 1.92 for S ‐ CPI . Conclusions Evaluation of β‐cell function using the glucagon stimulation test is useful for determining the efficacy of liraglutide introduction in patients with type 2 diabetes.