Liraglutide Plus Metformin Leads to Remission in New-Onset T2D

This article is part of Endocrinology Advisor‘s coverage of the 26th American Association of Clinical Endocrinologists (AACE) Annual Scientific Sessions & Clinical Congress, taking place in Austin, Texas. Our staff will report on medical research and technological advances in diabetes, obesity, and thyroid conditions, conducted by experts in the field. Check back regularly for more news from AACE 2017.

In a recent study of patients who were newly diagnosed with type 2 diabetes (T2DM), liraglutide combined with metformin led to remission in the majority of patients. The findings were presented at the 26th American Association of Clinical Endocrinologists (AACE) Annual Scientific Sessions & Clinical Congress, May 3-7, in Austin, Texas.

Liraglutide, a long-acting glucagon-like peptide-1 receptor agonist, addresses several components of T2DM pathogenesis via reductions in weight and blood glucose levels. It should thus be expected that the drug could lead to complete remission in patients with new-onset T2DM being treated under close supervision.

The present retrospective analysis focused on outcomes of 71 patients newly diagnosed with T2DM treated as part of a telemedicine integrated protocol to guide titration. Patients were initiated on liraglutide combined with metformin, along with insulin in some cases, and medications were tapered and discontinued during a period of 6 to 8 months. 

The majority of the patients (76.06%) were men; they had a mean age of 40.90±11.25 years. Improvements in numerous clinical parameters were found, as reflected in the following mean measures observed at baseline and the 6-month follow-up point:

• Baseline hemoglobin A1c: 8.27%±2.5%
• 6-month hemoglobin A1c: 5.96%±0.35% (P <.0001)
• Baseline fasting blood sugar: 155.8±57.0 mg/dL
• 6-month fasting blood sugar: 105.5±13.73 mg/dL (P <.0001)
• Baseline postprandial blood sugar: 179.4±85.81 mg/dL
• 6-month postprandial blood sugar: 105.0±20.20 mg/dL (P =.0003)
• Baseline body mass index: 30.50±4.0 kg/m²
• 6-month body mass index: 28.99±3.85 kg/m² (P <.0001)
• Baseline body weight: 86.34±13.36 kg
• 6-month body weight: 81.82±12.34 kg (P <.0001)
• Baseline waist circumference: 104.2±12.32 cm
• 6-month waist circumference: 98.08±8.94 cm (P =.0017)

In addition, the combined treatment regimen, either with or without insulin, led to complete remission at 2 years in 74% of patients “when administered via a telemedicine integrated protocol, and when tapered and discontinued over a period of 6 to 8 months,” the investigators reported.

These results warrant randomized controlled trials “in a wider population which will have a significant impact as a cost effective option for treating new onset diabetes,” they concluded.

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Reference

Kesavadev J, Shankar A, Thacker H, et al. Treatment outcomes with liraglutide in new onset type 2 diabetes — a retrospective analysis. Abstract 239. Presented at: 26th American Association of Clinical Endocrinologists Annual Scientific Sessions & Clinical Congress. May 3-7, 2017; Austin, TX.