New treatment combination effective in individuals with complex type 2 diabetes
A new combination of drugs can help individuals with complex type 2 diabetes lower their blood sugar levels, reducing their weight and use fewer insulin doses. This is shown in a study published in The British Medical Journal.
Individuals with type 2 diabetes who are treated with basal and mealtime insulin injections have few treatment options if their blood glucose is increased, other than increasing insulin doses. This often leads to a downward spiral with increased weight, which can have a negative effect on blood glucose.
In this study Swedish researchers have evaluated the effect of adding liraglutide, a drug that can be used along with oral antidiabetic drugs and basal insulin that has shown positive effects on blood glucose levels, to individuals with type 2 diabetes treated with basal and mealtime insulin.
The study was performed at 14 clinics in Sweden and included 124 participants with type 2 diabetes, overweight and increased blood glucose levels in spite of treatment with basal and mealtime insulin. Participants were randomly assigned to liraglutide or placebo (an inactive substance), and used their assigned drug/placebo for 24 weeks without making other changes to their treatment regimen.
Among all participants, 122 had enough data to be analysed. The main focus was the effect of liraglutide on HbA1c, weight and insulin doses. HbA1c is a test used to indicate blood glucose levels over the last three months. Results after 24 weeks showed that the liraglutide group reduced their HbA1c much more than placebo, with an average difference of 12.3 mmol/mol.
- In earlier studies, an Hba1c reduction of this magnitude has been shown to be associated with a considerably lower risk of developing long-term diabetic complications, according to principal investigator Dr. Marcus Lind.
Results also showed that the liraglutide group had weight reductions averaging 3.8 kg, while there was no change in the placebo group. The liraglutide group also had insulin doses that were lowered by 18.1 units, as compared to only 2.3 units in the placebo group.
These results are positive news for people with type 2 diabetes, as it provides another treatment option for those using a complex regimen consisting of basal and mealtime insulin injections. Treatment alternatives conforming to international clinical diabetes guidelines for these types of complex patients are sparse today, according to Dr Lind.
-In contrast to many other studies of novel glucose lowering agents, this study was performed independent of the manufacturer. Study coordination was performed by the NU Hospital Group in Uddevalla, according to study coordinator Sofia Dahlqvist.
The article Liraglutide in people treated for type 2 diabetes with multiple daily insulin injections: randomised clinical trial (MDI Liraglutide trial) was published in BMJ 28 October.
Link to the article: http://www.bmj.com/content/351/bmj.h5364
For more information please contact:
Marcus Lind, Sahlgrenska Academy, University of Gothenburg
070-08 242 39
Sofia Dahlqvist, Study coordinator, NU Hospital Group, Uddevalla
070-08 222 55
Sahlgrenska Academy, University of Gothenburg
46766-18 38 69
The Sahlgrenska Academy is the faculty of health sciences at the University of Gothenburg. Education and research are conducted within the fields of pharmacy, medicine, odontology and health care sciences. About 4,000 undergraduate students and 1,200 postgraduate students are enrolled at Sahlgrenska Academy. Around 1,400 people work at the Sahlgrenska Academy, 850 of them are researchers and/or teachers. 2013 Sahlgrenska Academy had a turnover of 2,4 billion SEK.