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Four weeks of treatment with liraglutide reduces insulin dose without loss of glycemic control in type 1 diabetic patients with and without residual beta-cell function.

ABSTRACT: To investigate the effect of 4 weeks of treatment with liraglutide on insulin dose and glycemic control in type 1 diabetic patients with and without residual ?-cell function.Ten type 1 diabetic patients with residual ?-cell function (C-peptide positive) and 19 without (C-peptide negative) were studied. All C-peptide-positive patients were treated with liraglutide plus insulin, whereas C-peptide-negative patients were randomly assigned to liraglutide plus insulin or insulin monotherapy. Continuous glucose monitoring with identical food intake and physical activity was performed before (week 0) and during (week 4) treatment. Differences in insulin dose; HbA1c; time spent with blood glucose<3.9, >10, and 3.9-9.9 mmol/L; and body weight were evaluated.Insulin dose decreased from 0.50±0.06 to 0.31±0.08 units/kg per day (P<0.001) in C-peptide-positive patients and from 0.72±0.08 to 0.59±0.06 units/kg per day (P<0.01) in C-peptide-negative patients treated with liraglutide but did not change with insulin monotherapy. HbA1c decreased in both liraglutide-treated groups. The percent reduction in daily insulin dose was positively correlated with ?-cell function at baseline, and two patients discontinued insulin treatment. In C-peptide-positive patients, time spent with blood glucose<3.9 mmol/L decreased from 3.0 to 1.0 h (P=0.03). A total of 18 of 19 patients treated with liraglutide lost weight during treatment (mean [range] -2.3±0.3 kg [-0.5 to -5.1]; P<0.001). Transient gastrointestinal adverse effects occurred in almost all patients treated with liraglutide.Treatment with liraglutide in type 1 diabetic patients reduces insulin dose with improved or unaltered glycemic control.

SUBMITTER: Kielgast U

PROVIDER: S-EPMC3120168 | biostudies-literature | 2011 Jul

REPOSITORIES: biostudies-literature

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Four weeks of treatment with liraglutide reduces insulin dose without loss of glycemic control in type 1 diabetic patients with and without residual beta-cell function.

Kielgast Urd U Krarup Thure T Holst Jens Juul JJ Madsbad Sten S

Diabetes care 20110518 7

<h4>Objective</h4>To investigate the effect of 4 weeks of treatment with liraglutide on insulin dose and glycemic control in type 1 diabetic patients with and without residual β-cell function.<h4>Research design and methods</h4>Ten type 1 diabetic patients with residual β-cell function (C-peptide positive) and 19 without (C-peptide negative) were studied. All C-peptide-positive patients were treated with liraglutide plus insulin, whereas C-peptide-negative patients were randomly assigned to lira ...[more]

PMID: 21593296

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Project description:Objective:This study aimed to explore whether treatment with the glucagon-like peptide-1 (GLP-1) analog liraglutide reduces intimal hyperplasia after coronary stent implantation via regulation of glycemic variability, the NLRP3 inflammasome, and IL-10 in diabetic swine. Methods:Fifteen pigs were divided into a diabetes mellitus (DM) group (n = 6), a DM + liraglutide treatment group (L group) (n = 6) and a sham group (n = 3). A total of 24 everolimus-eluting stents were implanted in the left anterior descending and right coronary arteries at 3 weeks. A novel continuous glucose monitoring system (GMS) was used for 2 weeks. The means and standard deviations (SDs) were measured and calculated by the GMS. At 22 weeks, the lumen area (LA), neointimal thickness (NIT), neointimal area (NIA), and percent area stenosis (%AS) were analyzed by optical coherence tomography. Plasma tumor necrosis factor-?, interleukin-6, and interleukin-10 were assayed by ELISA. The intima protein expression levels of NLRP3, interleukin-1?, interleukin-18 and interleukin-10 were examined using Western blot analysis. Histology was used to evaluate the healing response. In an in vitro study, THP-1 cells were divided into control, high glucose (HG), HG + liraglutide, and HG + liraglutide + Exe(9-39) (a GLP-1 receptor inhibitor) groups. Results:The L group had a lower SD, NIT, NIA, and %AS; a larger LA; reduced inflammation and injury scores; lower expression levels of tumor necrosis factor-?, interleukin-6, NLRP3, interleukin-1?, and interleukin-18; and higher expression of interleukin-10 compared with those of the DM group (p < 0.05). In the in vitro study, similar results were obtained in the HG + liraglutide group, and Exe(9-39) abolished the effect of liraglutide (p < 0.05). Conclusions:Liraglutide treatment reduces intimal hyperplasia after stent implantation via regulation of glycemic variability, the NLRP3 inflammasome, and IL-10 in diabetic pigs in a GLP-1 receptor-dependent manner. Reducing the inflammation induced by glycemic variability may be one of the cardioprotective mechanisms of liraglutide.

Project description:Background1-Deoxynojirimycin (DNJ), a component of mulberry leaf extract (MLE), reduces postprandial hyperglycemia by inhibiting intestinal a-glycosidase. The aim of this exploratory study was to investigate the effects of MLE on the glycemic indexes (GI) of common dietary carbohydrates.MethodsThis single-center, randomized, open-label, 7-cycle self-controlled crossover study enrolled 15 healthy volunteers at the National Drug Clinical Trial Institution, Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine (June 2014 to December 2014). The participants were randomized to receive glucose (3 occasions), glucose+MLE, sucrose+MLE, maltose+MLE, and maltodextrin+MLE orally during 7 visits (every 3 days). Blood glucose level was tested at 15 minutes before and at 15, 30, 45, 60, 90, and 120 minutes after carbohydrate intake. The GI of each carbohydrate relative to glucose (GI = 100) was calculated using the incremental area under the curve method. Safety was assessed at each visit.ResultsAll participants completed the protocol. After carbohydrate ingestion, blood glucose level peaked at 30 minutes (glucose, glucose+MLE, sucrose+MLE, and maltose+MLE) or 45 minutes (maltodextrin+MLE) before returning to preprandial levels at 120 minutes. At 30 minutes, the change in blood glucose level was lower for sucrose+MLE, maltose+MLE, and maltodextrin+MLE than for glucose or glucose+MLE (P < .05). GI was lowest for sucrose+MLE (43.22 ± 17.47) and maltose+MLE (49.23 ± 22.39), intermediate for maltodextrin+MLE (75.90 ± 26.01), and higher for glucose+MLE (91.88 ± 27.24). MLE reduced the GIs for maltose, sucrose, maltodextrin, and glucose by 53.11%, 33.51%, 31.00%, and 8.12%, respectively. MLE was well tolerated.ConclusionsCoconsumption of MLE with sucrose, maltose, or maltodextrin can reduce the GI values of these carbohydrates.Trial registrationChinese Clinical Trial Registry Platform, no. ChiCTR-IPR-15006484. Registered on May 28, 2015.

Dataset Information

Four weeks of treatment with liraglutide reduces insulin dose without loss of glycemic control in type 1 diabetic patients with and without residual beta-cell function.

Publications

Four weeks of treatment with liraglutide reduces insulin dose without loss of glycemic control in type 1 diabetic patients with and without residual beta-cell function.

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