GLP 1 receptor agonist superior in lowering glucose in diabetes patients treated with insulin

It is already known that GLP-1 RA is an antidiabetic agent. This potent agent benefits T2D patients with cardiorenal and weight-losing benefits. In an attempt to intensify insulin therapy in T2D patients, GLP-1 RA and basal insulin combination have been suggested in several clinical studies.

There is a lack of evidence (real world) comparing glycemic effects of GLP-1 RAs add-on to treatment (background) with and without insulin.

To investigate the background mentioned above, Hsuan-Wen Chou, with a team of researchers, did a retrospective study.

The study points are:

• Three hundred fifty-eight patients with a history of T2D started liraglutide or dulaglutide.
• A total of 147 patients were prior and concurrent users of insulin.
• There were 211 non-insulin users.
• Hemoglobin A1c (HbA1C) and body weight changes were evaluated after 12 months of treatment.
• There was greater effectiveness of GLP-1 RAs on HbA1C reduction in insulin users.
• Between insulin and non-insulin users, there was no difference in body weight significantly at 12 months (−1.42 kg vs −1.87 kg).
• The proportion of responders or decrease of HbA1C > 1% was much higher in insulin users than non-insulin users, 48% vs 37 %.
• Insulin users who had increased insulin dosage had significantly less HbA1C reduction compared to non-increased patients −0.62% vs −1.57%.

To conclude, GLP-1RAs have superior glucose-lowering effects in patients treated with insulin compared to non-insulin-treated patients with T2D. No significant differences in body weight decrease was recorded.

Further reading:

Chou, H.-W.; Cheng,K.-P.; Lin, A.-C.; Hung, H.-C.; Lin, C.-H.; Wang, C.-C.; Wu, H.-T.; Ou, H.-Y.Real-World Comparative Evaluation of Add-On Glucagon-like Peptide 1 ReceptorAgonist in Type 2 Diabetes Treated with or without Insulin. Pharmaceuticals 2022, 15, 1569. https://doi.org/10.3390/ph15121569