Predictors of Success for Insulin-to-Liraglutide Switch for Type 2 Diabetes
Patients who achieved a ≤HbA1c 7% had lower baseline HbA1c levels, shorter duration of insulin therapy, and shorter duration of diabetes.
The majority of patients with type 2 diabetes who switched from insulin therapy to the GLP-1 receptor agonist, liraglutide, continued this therapy for at least 1 year and experienced similar rates of glycemic control and an average of no change in body weight, according to a study published in Diabetes Therapy.
For patients whose type 2 diabetes cannot be adequately controlled with oral antidiabetic medications, GLP-receptor agonists may be equally effective as insulin.
This retrospective study analyzed the experiences of 104 patients who switched from insulin to liraglutide (57% female, mean body mass index 39.8 ± 5.4 kg/m2, mean age 57.2 ± 9.9 years) from January 2009 to February 2015, as well as their baseline characteristics, with the aim of determining possible predictors of success.
After 1 year, 58% of these patients (n=60) continued taking liraglutide. Of the remaining patients, 36% (n=37) discontinued therapy within 1 year due to poor glycemic control and 7% (n=7) discontinued due to intolerable side effects (6 out of 7 discontinued within the first 120 days of treatment).
Patients who successfully continued liraglutide therapy after 1 year had a significantly lower dose and frequency of insulin at baseline, and patients who achieved a glycated hemoglobin level of ≤ 7% (53 mmol/mol) had lower glycated hemoglobin levels at baseline and shorter durations of diabetes and insulin therapy.
Study investigators conclude that “this also indicates which patients on insulin can reduce their insulin dose after adding a GLP-1 receptor agonist.”
Bruinstroop E, Meyer L, Brouwer CB, van Rooijen DE, van Dam PS. Retrospective analysis of an insulin-to-liraglutide switch in patients with type 2 diabetes mellitus]. Diabetes Ther. 2918; 9(3):1369-1375.