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Effect of Liraglutide on Times in Glycaemic Ranges as Assessed by CGM for Type 2 Diabetes Patients Treated With Multiple Daily Insulin Injections

Sofizadeh, Sheyda ; Imberg, Henrik ; Ólafsdóttir, Arndís F. ; Ekelund, Magnus LU ; Dahlqvist, Sofia ; Hirsch, Irl ; Filipsson, Karin LU ; Ahrén, Bo LU ; Sjöberg, Stefan and Tuomilehto, Jaako , et al. (2019) In Diabetes Therapy 10(6). p.2115-2130
Abstract

Introduction: The effects of the GLP-1 analogue liraglutide on time in hypoglycaemia, time in hyperglycaemia, and time in range for type 2 diabetes patients initially treated with multiple daily insulin injections (MDI) were investigated. Variables associated with hypoglycaemia in the current population were also identified. Methods: Analyses were based on data from a previously performed double-blind, placebo-controlled trial in which 124 MDI-treated patients with type 2 diabetes were randomized to liraglutide or placebo. Masked continuous glucose monitoring (CGM) was performed at baseline and week 24 in 99 participants. Results: The mean time in hypoglycaemia was similar for participants receiving liraglutide and those receiving... (More)

Introduction: The effects of the GLP-1 analogue liraglutide on time in hypoglycaemia, time in hyperglycaemia, and time in range for type 2 diabetes patients initially treated with multiple daily insulin injections (MDI) were investigated. Variables associated with hypoglycaemia in the current population were also identified. Methods: Analyses were based on data from a previously performed double-blind, placebo-controlled trial in which 124 MDI-treated patients with type 2 diabetes were randomized to liraglutide or placebo. Masked continuous glucose monitoring (CGM) was performed at baseline and week 24 in 99 participants. Results: The mean time in hypoglycaemia was similar for participants receiving liraglutide and those receiving placebo after 24 weeks of treatment. Mean time in target was greater in the liraglutide group than in the placebo group: 430 versus 244 min/24 h (p < 0.001) and 960 versus 695 min/24 h (p < 0.001) for the two glycaemic ranges considered, 4–7 mmol/l and 4–10 mmol/l, respectively. Mean time in hyperglycaemia was lower in the liraglutide group: 457 versus 723 min/24 h (p = 0.001) and 134 versus 264 min/24 h (p = 0.023) for the two cutoffs considered, > 10 mmol/l and > 14 mmol/l, respectively. Lower mean glucose level, lower C-peptide, and higher glucose variability were associated with an increased risk of hypoglycaemia in both treatment groups. Higher proinsulin level was associated with a lower risk of hypoglycaemia in the liraglutide group. Conclusion: For type 2 diabetes patients initially treated with MDI, introducing liraglutide had a beneficial effect on glucose profiles estimated by masked CGM. Mean glucose level, glycaemic variability, C-peptide, and proinsulin level influenced the risk of hypoglycaemia in this population. Trial Registration: ClinicalTrials.gov, number (EudraCT nr: 2012-001941-42). Funding: Novo Nordisk funded this study. The Diabetes Research Unit, NU-Hospital Group funded the journal’s Rapid Service Fee.

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type
Contribution to journal
publication status
published
subject
keywords
Continuous glucose monitoring, Hyperglycaemia, Hypoglycaemia, Liraglutide, Placebo, Randomized clinical trial, Time in range, Type 2 diabetes mellitus
in
Diabetes Therapy
volume
10
issue
6
pages
2115 - 2130
publisher
Springer
external identifiers
  • scopus:85074038307
  • pmid:31564026
ISSN
1869-6953
DOI
10.1007/s13300-019-00692-1
language
English
LU publication?
yes
id
c88195a3-6786-4095-845c-5a14f0c23bf7
date added to LUP
2019-11-08 08:27:35
date last changed
2024-04-16 23:07:35
@article{c88195a3-6786-4095-845c-5a14f0c23bf7,
  abstract     = {{<p>Introduction: The effects of the GLP-1 analogue liraglutide on time in hypoglycaemia, time in hyperglycaemia, and time in range for type 2 diabetes patients initially treated with multiple daily insulin injections (MDI) were investigated. Variables associated with hypoglycaemia in the current population were also identified. Methods: Analyses were based on data from a previously performed double-blind, placebo-controlled trial in which 124 MDI-treated patients with type 2 diabetes were randomized to liraglutide or placebo. Masked continuous glucose monitoring (CGM) was performed at baseline and week 24 in 99 participants. Results: The mean time in hypoglycaemia was similar for participants receiving liraglutide and those receiving placebo after 24 weeks of treatment. Mean time in target was greater in the liraglutide group than in the placebo group: 430 versus 244 min/24 h (p &lt; 0.001) and 960 versus 695 min/24 h (p &lt; 0.001) for the two glycaemic ranges considered, 4–7 mmol/l and 4–10 mmol/l, respectively. Mean time in hyperglycaemia was lower in the liraglutide group: 457 versus 723 min/24 h (p = 0.001) and 134 versus 264 min/24 h (p = 0.023) for the two cutoffs considered, &gt; 10 mmol/l and &gt; 14 mmol/l, respectively. Lower mean glucose level, lower C-peptide, and higher glucose variability were associated with an increased risk of hypoglycaemia in both treatment groups. Higher proinsulin level was associated with a lower risk of hypoglycaemia in the liraglutide group. Conclusion: For type 2 diabetes patients initially treated with MDI, introducing liraglutide had a beneficial effect on glucose profiles estimated by masked CGM. Mean glucose level, glycaemic variability, C-peptide, and proinsulin level influenced the risk of hypoglycaemia in this population. Trial Registration: ClinicalTrials.gov, number (EudraCT nr: 2012-001941-42). Funding: Novo Nordisk funded this study. The Diabetes Research Unit, NU-Hospital Group funded the journal’s Rapid Service Fee.</p>}},
  author       = {{Sofizadeh, Sheyda and Imberg, Henrik and Ólafsdóttir, Arndís F. and Ekelund, Magnus and Dahlqvist, Sofia and Hirsch, Irl and Filipsson, Karin and Ahrén, Bo and Sjöberg, Stefan and Tuomilehto, Jaako and Lind, Marcus}},
  issn         = {{1869-6953}},
  keywords     = {{Continuous glucose monitoring; Hyperglycaemia; Hypoglycaemia; Liraglutide; Placebo; Randomized clinical trial; Time in range; Type 2 diabetes mellitus}},
  language     = {{eng}},
  month        = {{09}},
  number       = {{6}},
  pages        = {{2115--2130}},
  publisher    = {{Springer}},
  series       = {{Diabetes Therapy}},
  title        = {{Effect of Liraglutide on Times in Glycaemic Ranges as Assessed by CGM for Type 2 Diabetes Patients Treated With Multiple Daily Insulin Injections}},
  url          = {{http://dx.doi.org/10.1007/s13300-019-00692-1}},
  doi          = {{10.1007/s13300-019-00692-1}},
  volume       = {{10}},
  year         = {{2019}},
}