Real-World Comparative Evaluation of Add-On Glucagon-like Peptide 1 Receptor Agonist in Type 2 Diabetes Treated with or without Insulin
Glucagon-like peptide 1 receptor agonist (GLP-1 RA) is a potent antidiabetic agent with cardiorenal and weight-losing benefits in patients with type 2 diabetes (T2D). The combination of GLP-1 RA with basal insulin has been suggested in several clinical studies as a useful treatment for intensifying...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-12-01
|
| Series: | Pharmaceuticals |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1424-8247/15/12/1569 |
| _version_ | 1797455795157204992 |
|---|---|
| author | Hsuan-Wen Chou Kai-Pi Cheng An-Chi Lin Hao-Chang Hung Ching-Han Lin Chih-Chen Wang Hung-Tsung Wu Horng-Yih Ou |
| author_facet | Hsuan-Wen Chou Kai-Pi Cheng An-Chi Lin Hao-Chang Hung Ching-Han Lin Chih-Chen Wang Hung-Tsung Wu Horng-Yih Ou |
| author_sort | Hsuan-Wen Chou |
| collection | DOAJ |
| description | Glucagon-like peptide 1 receptor agonist (GLP-1 RA) is a potent antidiabetic agent with cardiorenal and weight-losing benefits in patients with type 2 diabetes (T2D). The combination of GLP-1 RA with basal insulin has been suggested in several clinical studies as a useful treatment for intensifying insulin therapy in T2D. However, there has been no real-world evidence study comparing the glycemic effects of GLP-1 RAs add-on to background treatment with and without insulin. A retrospective study was performed in 358 patients with T2D who initiated liraglutide or dulaglutide. Among them, 147 patients were prior and concurrent insulin users, and 211 patients were non-insulin users. After 12 months of GLP-1 RA treatment, the changes in hemoglobin A1c (HbA1C) and body weight were evaluated. The effectiveness of GLP-1 RAs on HbA1C reduction was greater in insulin users than non-insulin users at 12 months (−1.17% vs. −0.76%; <i>p</i> = 0.018). There was no significant difference in body weight change between insulin users and non-insulin users at 12 months (−1.42 kg vs. −1.87 kg; <i>p</i> = 0.287). The proportion of responders (decrease of HbA1C > 1%) in insulin users was much higher than that in non-insulin users (48% vs. 37 %; <i>p</i> = 0.04). In insulin users, those who had increased insulin dosage at 12 months had significantly less HbA1C reduction than that of non-increased patients (−0.62% vs. −1.57%; <i>p</i> = 0.001). GLP-1 RAs provide superior glucose-lowering effects in insulin-treated patients compared with non-insulin-treated patients with T2D without significant differences in body weight decrease. |
| first_indexed | 2024-03-09T15:58:54Z |
| format | Article |
| id | doaj.art-f54f1d0e2ae4486c80697c653dc7914b |
| institution | Directory Open Access Journal |
| issn | 1424-8247 |
| language | English |
| last_indexed | 2024-03-09T15:58:54Z |
| publishDate | 2022-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Pharmaceuticals |
| spelling | doaj.art-f54f1d0e2ae4486c80697c653dc7914b2023-11-24T17:17:27ZengMDPI AGPharmaceuticals1424-82472022-12-011512156910.3390/ph15121569Real-World Comparative Evaluation of Add-On Glucagon-like Peptide 1 Receptor Agonist in Type 2 Diabetes Treated with or without InsulinHsuan-Wen Chou0Kai-Pi Cheng1An-Chi Lin2Hao-Chang Hung3Ching-Han Lin4Chih-Chen Wang5Hung-Tsung Wu6Horng-Yih Ou7Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, TaiwanDepartment of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, TaiwanDepartment of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, TaiwanDivision of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813414, TaiwanDepartment of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, TaiwanDepartment of Internal Medicine, National Cheng Kung University Hospital Dou-Liou Branch, College of Medicine, National Cheng Kung University, Douliu 640003, TaiwanDepartment of Internal Medicine, School of Medicine, College of Medicine, National Cheng Kung University, Tainan 701401, TaiwanDepartment of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704302, TaiwanGlucagon-like peptide 1 receptor agonist (GLP-1 RA) is a potent antidiabetic agent with cardiorenal and weight-losing benefits in patients with type 2 diabetes (T2D). The combination of GLP-1 RA with basal insulin has been suggested in several clinical studies as a useful treatment for intensifying insulin therapy in T2D. However, there has been no real-world evidence study comparing the glycemic effects of GLP-1 RAs add-on to background treatment with and without insulin. A retrospective study was performed in 358 patients with T2D who initiated liraglutide or dulaglutide. Among them, 147 patients were prior and concurrent insulin users, and 211 patients were non-insulin users. After 12 months of GLP-1 RA treatment, the changes in hemoglobin A1c (HbA1C) and body weight were evaluated. The effectiveness of GLP-1 RAs on HbA1C reduction was greater in insulin users than non-insulin users at 12 months (−1.17% vs. −0.76%; <i>p</i> = 0.018). There was no significant difference in body weight change between insulin users and non-insulin users at 12 months (−1.42 kg vs. −1.87 kg; <i>p</i> = 0.287). The proportion of responders (decrease of HbA1C > 1%) in insulin users was much higher than that in non-insulin users (48% vs. 37 %; <i>p</i> = 0.04). In insulin users, those who had increased insulin dosage at 12 months had significantly less HbA1C reduction than that of non-increased patients (−0.62% vs. −1.57%; <i>p</i> = 0.001). GLP-1 RAs provide superior glucose-lowering effects in insulin-treated patients compared with non-insulin-treated patients with T2D without significant differences in body weight decrease.https://www.mdpi.com/1424-8247/15/12/1569diabetesGlucagon-like peptide 1 receptor agonistsglycemic controlinsulinreal world study |
| spellingShingle | Hsuan-Wen Chou Kai-Pi Cheng An-Chi Lin Hao-Chang Hung Ching-Han Lin Chih-Chen Wang Hung-Tsung Wu Horng-Yih Ou Real-World Comparative Evaluation of Add-On Glucagon-like Peptide 1 Receptor Agonist in Type 2 Diabetes Treated with or without Insulin Pharmaceuticals diabetes Glucagon-like peptide 1 receptor agonists glycemic control insulin real world study |
| title | Real-World Comparative Evaluation of Add-On Glucagon-like Peptide 1 Receptor Agonist in Type 2 Diabetes Treated with or without Insulin |
| title_full | Real-World Comparative Evaluation of Add-On Glucagon-like Peptide 1 Receptor Agonist in Type 2 Diabetes Treated with or without Insulin |
| title_fullStr | Real-World Comparative Evaluation of Add-On Glucagon-like Peptide 1 Receptor Agonist in Type 2 Diabetes Treated with or without Insulin |
| title_full_unstemmed | Real-World Comparative Evaluation of Add-On Glucagon-like Peptide 1 Receptor Agonist in Type 2 Diabetes Treated with or without Insulin |
| title_short | Real-World Comparative Evaluation of Add-On Glucagon-like Peptide 1 Receptor Agonist in Type 2 Diabetes Treated with or without Insulin |
| title_sort | real world comparative evaluation of add on glucagon like peptide 1 receptor agonist in type 2 diabetes treated with or without insulin |
| topic | diabetes Glucagon-like peptide 1 receptor agonists glycemic control insulin real world study |
| url | https://www.mdpi.com/1424-8247/15/12/1569 |
| work_keys_str_mv | AT hsuanwenchou realworldcomparativeevaluationofaddonglucagonlikepeptide1receptoragonistintype2diabetestreatedwithorwithoutinsulin AT kaipicheng realworldcomparativeevaluationofaddonglucagonlikepeptide1receptoragonistintype2diabetestreatedwithorwithoutinsulin AT anchilin realworldcomparativeevaluationofaddonglucagonlikepeptide1receptoragonistintype2diabetestreatedwithorwithoutinsulin AT haochanghung realworldcomparativeevaluationofaddonglucagonlikepeptide1receptoragonistintype2diabetestreatedwithorwithoutinsulin AT chinghanlin realworldcomparativeevaluationofaddonglucagonlikepeptide1receptoragonistintype2diabetestreatedwithorwithoutinsulin AT chihchenwang realworldcomparativeevaluationofaddonglucagonlikepeptide1receptoragonistintype2diabetestreatedwithorwithoutinsulin AT hungtsungwu realworldcomparativeevaluationofaddonglucagonlikepeptide1receptoragonistintype2diabetestreatedwithorwithoutinsulin AT horngyihou realworldcomparativeevaluationofaddonglucagonlikepeptide1receptoragonistintype2diabetestreatedwithorwithoutinsulin |