Liraglutide hospital discharge trial: A randomized controlled trial comparing the safety and efficacy of liraglutide versus insulin glargine for the management of patients with type 2 diabetes after hospital discharge

Abstract

Aim To compare a glucagon‐like peptide‐1 receptor agonist with basal insulin at hospital discharge in patients with uncontrolled type 2 diabetes in a randomized clinical trial. Methods A total of 273 patients with glycated haemoglobin (HbA1c) 7%–10% (53–86 mol/mol) were randomized to liraglutide (n = 136) or insulin glargine (n = 137) at hospital discharge. The primary endpoint was difference in HbA1c at 12 and 26 weeks. Secondary endpoints included hypoglycaemia, changes in body weight, and achievement of HbA1c <7% (53 mmol/mol) without hypoglycaemia or weight gain. Results The between‐group difference in HbA1c at 12 weeks and 26 weeks was −0.28% (95% CI −0.64, 0.09), and at 26 weeks it was −0.55%, (95% CI −1.01, −0.09) in favour of liraglutide. Liraglutide treatment resulted in a lower frequency of hypoglycaemia <3.9 mmol/L (13% vs 23%; P = 0.04), but there was no difference in the rate of clinically significant hypoglycaemia <3.0 mmol/L. Compared to insulin glargine, liraglutide treatment was associated with greater weight loss at 26 weeks (−4.7 ± 7.7 kg vs −0.6 ± 11.5 kg; P < 0.001), and the proportion of patients with HbA1c <7% (53 mmol/mol) without hypoglycaemia was 48% versus 33% (P = 0.05) at 12 weeks and 45% versus 33% (P = 0.14) at 26 weeks in liraglutide versus insulin glargine. The proportion of patients with HbA1c <7% (53 mmol/mol) without hypoglycaemia and no weight gain was higher with liraglutide at 12 (41% vs 24%, P = 0.005) and 26 weeks (39% vs 22%; P = 0.014). The incidence of gastrointestinal adverse events was higher with liraglutide than with insulin glargine (P < 0.001). Conclusion Compared to insulin glargine, treatment with liraglutide at hospital discharge resulted in better glycaemic control and greater weight loss, but increased gastrointestinal adverse events.

Liraglutide on type 2 diabetes mellitus with nonalcoholic fatty liver disease: A systematic review and meta-analysis of 16 RCTs

“…It usually reflects the glycemic situation of patients for nearly 8 to 12 weeks. [ 63 ] HbA1c is a better indicator for blood glucose controlling and complications preventing during recent 2 to 3 months. [ 64 ] In this study, liraglutide can decrease HbA1c level of T2DM with NAFLD.…”

Weight Loss Effects of Glucagon-Like Peptide-One Receptor Analog Treatment in a Severely Obese Patient During Hospital Admission

“…While GLP-1RAs are widely used and effective in the outpatient setting, there are no current guidelines for hospitalized patients. However, a recent RCT showed the beneficial effects of liraglutide versus glargine insulin at hospital discharge [ 17 ].…”

Glucagon‐like peptide‐1 receptor agonist prescribing patterns in adolescents with type 2 diabetes

“…9 In adults, GLP-1RAs have been found to reduce weight, improve glycaemic control, and decrease insulin dosage. [10][11][12][13][14][15][16][17][18] Therefore, GLP-1RAs were an attractive 'off-label' adjunct therapy in youth with T2D and obesity to reduce body weight and HbA1c prior to the FDA approval of liraglutide and exenatide ER. [19][20][21] As more GLP-1RAs become FDA approved, an area of additional research should be to evaluate how prescribing patterns change over time with increasing access to these medications.…”