Efficacy of liraglutide, a glucagon-like peptide-1 (GLP-1) analogue, on body weight, eating behavior, and glycemic control, in Japanese obese type 2 diabetes

Abstract

BackgroundWe recently reported that short-term treatment with liraglutide (20.0 ± 6.4 days) reduced body weight and improved some scales of eating behavior in Japanese type 2 diabetes inpatients. However, it remained uncertain whether such liraglutide-induced improvement is maintained after discharge from the hospital. The aim of the present study was to determine the long-term effects of liraglutide on body weight, glycemic control, and eating behavior in Japanese obese type 2 diabetics.MethodsPatients with obesity (body mass index (BMI) >25 kg/m2) and type 2 diabetes were hospitalized at Osaka University Hospital between November 2010 and December 2011. BMI and glycated hemoglobin (HbA1c) were examined on admission, at discharge and at 1, 3, and 6 months after discharge. For the liraglutide group (BMI; 31.3 ± 5.3 kg/m2, n = 29), patients were introduced to liraglutide after correction of hyperglycemic by insulin or oral glucose-lowering drugs and maintained on liraglutide after discharge. Eating behavior was assessed in patients treated with liraglutide using The Guideline For Obesity questionnaire issued by the Japan Society for the Study of Obesity, at admission, discharge, 3 and 6 months after discharge. For the insulin group (BMI; 29.1 ± 3.0 kg/m2, n = 28), each patient was treated with insulin during hospitalization and glycemic control maintained by insulin after discharge.ResultsLiraglutide induced significant and persistent weight loss from admission up to 6 months after discharge, while no change in body weight after discharge was noted in the insulin group. Liraglutide produced significant improvements in all major scores of eating behavior questionnaire items and such effect was maintained at 6 months after discharge. Weight loss correlated significantly with the decrease in scores for recognition of weight and constitution, sense of hunger, and eating style.ConclusionLiraglutide produced meaningful long-term weight loss and significantly improved eating behavior in obese Japanese patients with type 2 diabetes.

Effects of exenatide on metabolic parameters/control in obese Japanese patients with type 2 diabetes

“…It has been reported that obese people are often associated with characteristic eating behavior, such as overeating, lack of a sense of fullness, desire for fatty/lipidrich foods and short mealtime [9]. In the present study, medical interviews revealed that patients treated with exenatide ate less snacks and fatty/lipid-rich foods and took a longer time for eating.…”

Liraglutide: A Review of Its Use in the Management of Obesity

“…In obese adults with or without type 2 diabetes, shortterm liraglutide treatment reduced bodyweight by decreasing calorie intake and improving eating behaviour and food choices, with no increase in 24-h energy expenditure, [20][21][22][23]. For instance, at 5 weeks, the mean estimated energy intake during an ad libutum lunch was significantly reduced (by &16 %) in liraglutide 1.8 and 3 mg/day recipients compared with placebo recipients (estimated mean energy intake 3004 and 3024 vs. 3592 kJ; p B 0.003) [21].…”

Mechanisms underlying weight loss and metabolic improvements in rodent models of bariatric surgery

“…While long-acting GLP-1 agonists are the only type 2 diabetes medications that cause weight loss, the degree of weight loss is considerably less, with estimates of around a third of that achieved by metabolic surgery [64]. Similarly, chronic treatment with pharmacological doses of long-acting GLP-1 agonists alone fail to produce the same magnitude of effects as the degree of weight loss caused by RYGB and VSG and, indeed, these drugs are often used in combination with other pharmacological interventions to treat type 2 diabetes [64–66]. Moreover, GLP-1 antagonists fail to impair the otherwise improved glucose tolerance after VSG in humans [67].…”