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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

Lind, Marcus ; Jendle, Johan ; Torffvit, Ole LU and Lager, Ibe (2012) In Primary Care Diabetes 6(1). p.41-46
Abstract
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... (More)
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 52.2 U (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. (C) 2011 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved. (Less)
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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
GLP-1 analogue, Insulin, Combination, Treatment satisfaction
in
Primary Care Diabetes
volume
6
issue
1
pages
41 - 46
publisher
Elsevier
external identifiers
  • wos:000304279800007
  • scopus:84858079439
  • pmid:22015237
ISSN
1878-0210
DOI
10.1016/j.pcd.2011.09.002
language
English
LU publication?
yes
id
abc64a49-c0de-404e-aadb-6d7b0b10d308 (old id 2809757)
date added to LUP
2016-04-01 10:51:13
date last changed
2022-02-10 06:33:39
@article{abc64a49-c0de-404e-aadb-6d7b0b10d308,
  abstract     = {{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 &lt; 0.001), weight decreased from 111.1 kg to 104.0 kg (p&lt;0.001) and insulin doses were reduced from 91.1U to 52.2 U (p &lt; 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&lt;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. (C) 2011 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.}},
  author       = {{Lind, Marcus and Jendle, Johan and Torffvit, Ole and Lager, Ibe}},
  issn         = {{1878-0210}},
  keywords     = {{GLP-1 analogue; Insulin; Combination; Treatment satisfaction}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{41--46}},
  publisher    = {{Elsevier}},
  series       = {{Primary Care Diabetes}},
  title        = {{Glucagon-like peptide 1 (GLP-1) analogue combined with insulin reduces HbA1c and weight with low risk of hypoglycemia and high treatment satisfaction}},
  url          = {{http://dx.doi.org/10.1016/j.pcd.2011.09.002}},
  doi          = {{10.1016/j.pcd.2011.09.002}},
  volume       = {{6}},
  year         = {{2012}},
}