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Glucagon-like peptide 1 (GLP-1) analogue combined with insulin reduces HbA1c and weight with low risk of hypoglycemia and high treatment satisfaction
Department of Molecular and Clinical Medicine, Institute of Medicine Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Medicine, NU-Hospital Organization, Uddevalla, Sweden.
Endocrine and Diabetes Centre, Karlstad Hospital, Karlstad, Sweden; Faculty of Medicine and Health, Örebro University Hospital, Örebro, Sweden.ORCID iD: 0000-0003-1025-1682
Department of Nephrology, Institute of Clinical Sciences, Lund University, Lund, Sweden.
Department of Medicine, Krinstianstad Hospital, Kristianstad, Sweden.
2012 (English)In: Primary Care Diabetes, ISSN 1751-9918, E-ISSN 1878-0210, Vol. 6, no 1, p. 41-46Article in journal (Refereed) Published
Abstract [en]

Aims: To evaluate the effects of adding glucagon-like peptide-1 (GLP-1) analogue therapy to insulin on glycated hemoglobin (HbA1c), weight, insulin dosage, treatment satisfaction, and risk of hypoglycaemia.

Methods: Type 2 diabetes patients with insulin therapy receiving a GLP-1 analogue at 4 Swedish centers were studied. Hypoglycemia was evaluated using glucometers and patient self-report. The Diabetes Treatment Satisfaction Questionnaire (DTSQ) was used to evaluate treatment satisfaction.

Results: Among 65 patients studied, 4 discontinued therapy, none due to hypoglycemia, and there were no suspected severe adverse events. Among 61 patients who remained on therapy over a mean of 7.0 months, 40 were treated with liraglutide and 21 with exenatide. HbA1c decreased from a mean of 8.9% (82.4 mmol/mol) to 7.9% (71.9 mmol/mol) (p<0.001), weight decreased from 111.1 kg to 104.0 kg (p<0.001) and insulin doses were reduced from 91.1U to 52.2U (p<0.001). There was one patient with severe hypoglycemia. The mean number of asymptomatic hypoglycemia per patient and month, reported for the last month (0.085 below 4.0 mmol/l and 0 below 3.0 mmol/l) and documented symptomatic hypoglycemia (0.24 below 4.0 mmol/l and 0.068 below 3.0 mmol/l) was low. The DTSQc showed higher treatment satisfaction than with the previous regimen of 11.9 (scale -18 to +18 points, p<0.001).

Conclusions: The addition of GLP-1 analogues to insulin in patients with type 2 diabetes is associated with reductions in HbA1c, weight, and insulin dose, along with a low risk of hypoglycemia and high treatment satisfaction.

Place, publisher, year, edition, pages
Oxon, United Kingdom: Elsevier, 2012. Vol. 6, no 1, p. 41-46
Keywords [en]
GLP-1 analogue. insulin, combination, treatment satisfaction
National Category
Medical and Health Sciences Endocrinology and Diabetes
Research subject
Medicine
Identifiers
URN: urn:nbn:se:oru:diva-27349DOI: 10.1016/j.pcd.2011.09.002ISI: 000304279800007PubMedID: 22015237Scopus ID: 2-s2.0-84858079439OAI: oai:DiVA.org:oru-27349DiVA, id: diva2:603499
Available from: 2013-02-06 Created: 2013-02-06 Last updated: 2017-12-06Bibliographically approved

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