Liraglutide changes body composition and lowers added sugar intake in overweight persons with insulin pump‐treated type 1 diabetes

Abstract

Aims: To present secondary outcome analyses of liraglutide treatment in overweight adults with insulin pump-treated type 1 diabetes (T1D), focusing on changes in body composition and dimensions, and to evaluate changes in food intake to identify potential dietary drivers of liraglutide-associated weight loss. Materials and methods:A 26-week randomized placebo-controlled study was conducted to investigate the efficacy and safety of liraglutide 1.8 mg daily in 44 overweight adults with insulin pump-treated T1D and glucose levels above target, and demonstrated significant glycated haemoglobin (HbA1c)-and body weight-reducing effects. For secondary outcome analysis, dual X-ray absorptiometry scans were completed at Weeks 0 and 26, and questionnaire-based food frequency recordings were obtained at Weeks 0, 13 and 26 to characterize liraglutide-induced changes in body composition and food intake.Results: Total fat and lean body mass decreased in liraglutide-treated participants (fat mass À4.6 kg [95% confidence interval {CI} À5.7; À3.5], P < 0.001; lean mass À2.5 kg [95% CI À3.2;-1.7], P < 0.001), but remained stable in placebo-treated participants (fat mass À0.3 kg [95% CI À1.3;0.8], P = 0.604; lean mass 0.0 kg [95% CI À0.7;0.7]; P = 0.965 [between-group P values <0.001]). Participants reduced their energy intake numerically more in the liraglutide arm (À1.1 MJ [95% CI À2.0;-0.02], P = 0.02) than in the placebo arm (À0.9 MJ [95% CI À2.0;0.1], P = 0.22), but the between-group difference was statistically insignificant (P = 0.42). However, energy derived from added sugars decreased by 27% in the liraglutide arm compared with an increase of 14% in the placebo arm (P = 0.004).Conclusions: Liraglutide lowered fat and lean body mass compared with placebo.Further, liraglutide reduced intake of added sugars. However, no significant difference in total daily energy intake was detected between liraglutide-and placebotreated participants.

The emergence of obesity in type 1 diabetes

“…A secondary outcome analysis of the Lira pump trial ( n = 44) reported that liraglutide 1.8 mg lowered fat mass [ 71 ]. Concerningly, it was accompanied by a reduction in lean mass (−2.5 kg vs. 0 kg in the placebo group; p < 0.001) [ 71 ].…”

“…A secondary outcome analysis of the Lira pump trial ( n = 44) reported that liraglutide 1.8 mg lowered fat mass [ 71 ]. Concerningly, it was accompanied by a reduction in lean mass (−2.5 kg vs. 0 kg in the placebo group; p < 0.001) [ 71 ]. This finding should be interpreted with caution as there was no emphasis on dietary guidance provided in the study [ 71 ].…”

“…Concerningly, it was accompanied by a reduction in lean mass (−2.5 kg vs. 0 kg in the placebo group; p < 0.001) [ 71 ]. This finding should be interpreted with caution as there was no emphasis on dietary guidance provided in the study [ 71 ]. Additional studies are needed to gain insights into the mediating role of adjunct low-caloric diet.…”

Treating obesity in type 1 diabetes mellitus – review of efficacy and safety

“…Additionally, there were no episodes of diabetic ketoacidosis; gastrointestinal adverse effects occurred more commonly with liraglutide. The same group published a follow-up study presenting a secondary analysis focusing on body composition and change in food intake [33 ▪ ]. They reported reductions in total fat (−4.6 kg) and lean body (−2.5 kg) mass with the use of liraglutide; energy intake was also lower with liraglutide.…”