Effect of Liraglutide on Times in Glycaemic Ranges as Assessed by CGM for Type 2 Diabetes Patients Treated With Multiple Daily Insulin Injections
Journal article, 2019

© 2019, The Author(s). 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.

Type 2 diabetes mellitus

Time in range

Placebo

Hyperglycaemia

Continuous glucose monitoring

Liraglutide

Hypoglycaemia

Randomized clinical trial

Author

Sheyda Sofizadeh

University of Gothenburg

NU Hospital Group

Henrik Imberg

Statistiska Konsultgruppen

Chalmers, Mathematical Sciences, Applied Mathematics and Statistics

Arndís F. Ólafsdóttir

NU Hospital Group

University of Gothenburg

Magnus Ekelund

Lund University

Novo Nordisk

S. Dahlqvist

NU Hospital Group

University of Gothenburg

Irl B. Hirsch

University of Washington

Karin Filipsson

Lund University

Bo Ahrén

Lund University

Stefan Sjöberg

Karolinska University Hospital

Jaako Tuomilehto

University of Helsinki

King Abdulaziz University

National Institute for Health and Welfare

Marcus Lind

University of Gothenburg

NU Hospital Group

Diabetes Therapy

1869-6953 (ISSN) 1869-6961 (eISSN)

Subject Categories

Endocrinology and Diabetes

Other Clinical Medicine

General Practice

DOI

10.1007/s13300-019-00692-1

More information

Latest update

11/8/2019