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Liraglutide Potentially Preserves Pancreatic Beta Cell Function

Liraglutide can preserve beta cell function over 48 weeks following initial elimination of glucotoxicity….

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A double blind, randomized, controlled trial was conducted in 51 patients with type 2 diabetes of 2.6+/- 1.9 years duration and an A1c of 6.8 +/- 0.8%. Intensive insulin therapy (IIT) was completed over 4 weeks before randomization to daily subcutaneous liraglutide or placebo injection. If participants had an A1c >8%, metformin was administered at 500mg twice daily for the first 2 weeks for increasing to 1,000mg twice daily for the duration of the trial. At week 48, participants stopped their study medication before undertaking a washout OGTT 2 weeks. Insulin Secretion-Sensitivity Index-2 was used to assess beta cell function.

At 48 weeks, the liraglutide group had a higher beta cell function compared to the placebo group (339.8 +/- 27.8 vs 229.3 +/- 28.4, P=0.008). HbA1c was lower in the liraglutide group (6.2% vs 6.6%, P=0.055). No incidence of hypoglycemia was seen between the liraglutide and placebo group (P=0.61). After 2 weeks of stopping treatment, the beneficial effect on ISSI-2 of liraglutide vs placebo was lost (191.9 +/- 24.7 vs 238.1 +/- 25.2, P=0.20).

Practice Pearls:

  • Benefits of liraglutide on beta cell function were seen up to 1-2 years of treatment.
  • More studies need to be done on the long-term effects of liraglutide in type 2 diabetes.
  • This is the first study to eliminate the confounding influence of glucotoxity in examining the effects of liraglutide.

Retnakaran R, Kramer C, Choi H, et al. "Liraglutide and the preservation of pancreatic b-cell function in early type 2 diabetes: the LIBRA trial". American Diabetes Association. September 23, 2014. http://care.diabetesjournals.org/content/37/12/3270.full