GLP-1 receptor agonists use in youth with type 2 diabetes tied to decreased HbA1c levels: Study

The findings, published in Diabetes, Obesity and Metabolism, suggest that GLP-1RA treatment may reduce insulin doses for youth with type 2 diabetes.

Stephanie L. Samuels, Yale University School of Medicine, New Haven, Connecticut, USA, and colleagues conducted a multicentre retrospective study to assess the short-term, real-world use and effectiveness of GLP-1 receptor agonist medications in the management of T2D in a diverse cohort of youth.

The researchers analyzed youth prescribed a GLP-1RA for T2D management at two academic paediatric diabetes centres before June 2022. Changes in insulin use and HbA1c from baseline to first (median 91 days) and second (median 190 days) follow-up were determined for those taking a GLP-1 receptor agonist.

Multivariable linear mixed-effects models adjusting for baseline age, sex, race/ethnicity, metformin regimen, insulin regimen, GLP-1RA dosing frequency, and the body mass index Z-score (BMI-Z) examined the HbA1c change for participants for up to 6 months after baseline.

One hundred and thirty-six patients with type 2 diabetes (median age 16.1 years, 54% female) were prescribed GLP-1RAs and taking them at the first or second follow-up.

The researchers reported the following findings:

• There was a decrease in median HbA1c from 7.9% to 7.6% at a median follow-up of 91 days (n = 109) and, among those with HbA1c available at baseline and second follow-up (n = 83), from 8.4% to 7.4%.
• The proportion of patients prescribed insulin decreased from baseline to the first follow-up visit (basal 69% to 60%, prandial 46% to 38%).
• In multivariable analysis, there was a mean decrease in HbA1c by 0.09 percentage points per month.

"Youth with type 2 diabetes had decreases in A1C levels when taking glucagon-like peptide-1 receptor agonists," the researchers wrote.

"Sustained reduction in A1C for the six months of the study was primarily seen in children who reported partial or complete adherence to GLP-1RAs."

Reference:

Samuels SL, Chajecki A, Hu P, Kayser M, Weyman K, Pan B, Brown EA, Van Name M, Wolf RM. Real-world use of glucagon-like peptide-1 receptor agonists in youth with type 2 diabetes is associated with short-term improvements in HbA1c. Diabetes Obes Metab. 2024 Jan 16. doi: 10.1111/dom.15430. Epub ahead of print. PMID: 38229444.