Near‐normalization of glycaemic control with glucagon‐like peptide‐1 receptor agonist treatment combined with exercise in patients with type 2 diabetes

Mensberg, Pernille; Nyby, Signe; Jørgensen, Peter Godsk; Storgaard, Heidi; Jensen, Magnus Thorsten; Sivertsen, Jacob; Holst, Jens J.; Kiens, Bente; Knop, Filip K.; Vilsbøll, Tina

doi:10.1111/dom.12797

Cited by 41 publications

(55 citation statements)

References 41 publications

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“…The present study was a predefined sub-study reporting echocardiographic data from a study evaluating the gluco-metabolic effect of liraglutide or placebo in combination with supervised exercise in patients with type 2 diabetes. 4 In brief, this was a single-centre, 16-week, randomized, double-blind, placebo-controlled study conducted between groups, P = .32) and no significant differences in LV structure, including wall diameters, internal dimension and mass within or between the placebo and the liraglutide groups were observed. LV systolic function, ejection fraction and global longitudinal strain, were also similar within and between the 2 groups.…”

Section: Methodsmentioning

confidence: 95%

“…The present study was a predefined sub‐study reporting echocardiographic data from a study evaluating the gluco‐metabolic effect of liraglutide or placebo in combination with supervised exercise in patients with type 2 diabetes . In brief, this was a single‐centre, 16‐week, randomized, double‐blind, placebo‐controlled study conducted at the Centre for Diabetes Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.…”

Section: Methodsmentioning

confidence: 99%

“…Informed consent was obtained from all patients before inclusion. The exercise training consisted of three 60‐minute supervised training sessions per week as previously described . The trial drugs used were the GLP‐1 analogue, liraglutide (Victoza) or placebo, which was supplied by Novo Nordisk in blinded pens for subcutaneous injections.…”

Section: Methodsmentioning

confidence: 99%

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Effect of exercise combined with glucagon‐like peptide‐1 receptor agonist treatment on cardiac function: A randomized double‐blind placebo‐controlled clinical trial

Jørgensen

Jensen

Mensberg

et al. 2017

Diabetes Obesity Metabolism

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In patients with type 2 diabetes, both supervised exercise and treatment with the glucagon-like peptide-1 (GLP-1) receptor agonist (GLP-1RA) liraglutide may improve cardiac function. We evaluated cardiac function before and after 16 weeks of treatment with the GLP-1RA liraglutide or placebo, combined with supervised exercise, in 33 dysregulated patients with type 2 diabetes on diet and/or metformin. Early diastolic myocardial tissue velocity was improved by exercise in the placebo group (mean AE standard deviation [s.d.] −7.1 AE 1.6 to −7.7 AE 1.8 cm/s, P = .01), but not in the liraglutide group (−7.1 AE 1.4 to −7.0 AE 1.4 cm/s, P = .60; between groups, P = .02). Similarly, the mean AE s.d. ratio of early and atrial mitral annular tissue velocities improved in the placebo group (1.0 AE 0.4 to 1.2 AE 0.4, P = .003), but not in the liraglutide group (1.0 AE 0.3 to 1.0 AE 0.3, P = .87; between groups, P = .03). We found no significant differences in heart rate, left ventricular (LV) structure or function within or between the groups.In conclusion, the addition of liraglutide to exercise in sedentary patients with dysregulated type 2 diabetes may blunt the suggested beneficial effect of exercise on LV diastolic function. K E Y W O R D Scardiovascular disease, exercise, liraglutide | INTRODUCTIONIn patients with type 2 diabetes, studies examining the effect of exercise on cardiac function have had conflicting results, and the effect of exercise intervention seems to be related to the type, duration and intensity of the exercise. Accordingly, in a study in 223 patients undergoing a 12-month exercise intervention, myocardial function was only improved in response to moderate and vigorous exercise. 2 Both exercise and liraglutide have a complex interaction with the cardiovascular system, affecting both blood pressure and heart rate, 3 and it is unknown how cardiac function is affected by the combination of exercise and liraglutide. We recently reported that treatment with the GLP-1RA liraglutide in addition to exercise was superior to placebo in terms of glycaemic control and body weight loss in dysregulated patients with type 2 diabetes on

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Section: Methodsmentioning

confidence: 95%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Effect of exercise combined with glucagon‐like peptide‐1 receptor agonist treatment on cardiac function: A randomized double‐blind placebo‐controlled clinical trial

Jørgensen

Jensen

Mensberg

et al. 2017

Diabetes Obesity Metabolism

View full text Add to dashboard Cite

show abstract

“…In a sample of overweight participants with Type 2 diabetes and suboptimal glycaemic control, liraglutide, in combination with a 16‐week exercise training programme (consisting of cycling and resistance exercises), demonstrated greater reductions in fasting plasma glucose compared with a placebo and training arm (–3.4 ± 2.3 vs –0.3 ± 2.6 mmol/l; P <0.05), and HbA 1c (2.0% ± 1.2% vs 0.3% ± 0.9%; P <0.05) . Liraglutide in combination with exercise training also improved body mass and blood pressure compared with a placebo and exercise training group, although similar changes in estimated percent body fat, VO 2peak and quality‐of‐life markers were noted between the groups in response to exercise training .…”

Section: Glucagon‐like Peptide‐1 Receptor Agonistsmentioning

confidence: 96%

Physical exercise and non‐insulin glucose‐lowering therapies in the management of Type 2 diabetes mellitus: a clinical review

et al. 2018

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In the UK the National Institute of Health and Care Excellence (NICE) advocates intensive lifestyle programmes that attain the levels of daily physical activity set out by the Chief Medical Officer as a first‐line strategy for improving the health of people at risk of developing diabetes or reducing the risk of development of Type 2 diabetes. For people with Type 2 diabetes, lifestyle measures complement pharmacological treatments that include both oral and injectable therapies. In line with this, NICE guidelines also support intensification of efforts to improve patient lifestyle along with these glucose‐lowering therapies. There is a paucity of evidence, however, in the available published literature examining the association between glucose‐lowering therapies and exercise metabolism. In the present review we explore the current knowledge with regard to the potential interactions of oral and non‐insulin injectable therapies with physical activity in people at risk of, or who have, Type 2 diabetes, and present evidence that may inform healthcare professionals of the need to monitor patients more closely in their adaptation to both pharmacological therapy and physical activity.

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“…ª 2019 Diabetes UK from the pancreas. In people with type 2 diabetes, liraglutide (a GLP-1 receptor agonist) added to a 16week exercise programme resulted in greater reductions in HbA 1c , weight and blood pressure compared to exercise alone [39].…”

Section: Dpp-4 Inhibitors No Studies No Studies Sglt2 Inhibitorsmentioning

confidence: 99%

James Lind Alliance research priorities: should diet and exercise be used as an alternative to drugs for the management of type 2 diabetes or alongside them?

England

2020

Diabet. Med.

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Aim To review evidence on whether diet and exercise should be used as an alternative to drug therapy for the management of type 2 diabetes or alongside. Method We present a narrative review that draws on evidence from other systematic reviews and meta‐analyses, narrative reviews, trials and cohort studies. We focused mainly on glycaemic control rather than control of blood pressure or cholesterol. Results Good‐quality dietary advice that results in weight loss of >5% and physical activity interventions of >150 min/week of moderate to vigorous physical activity, combined with resistance exercise, can produce improvements in HbA1c similar to those produced by the addition of glucose‐lowering drugs. These improvements can be seen at all stages of the disease. There are recognized interactions between glucose‐lowering drugs and physical activity which may not be synergistic, but these are not well understood, and it is not clear if they are considered in clinical practice. Studies that explicitly compare drugs with diet or physical activity or control for drug use found that lifestyle could delay or reduce medication use, but most people eventually needed to progress to drug treatment. There are few studies, however, that provide strategies for the long‐term maintenance of weight loss or physical activity. Conclusion Diet and physical activity are of key importance in type 2 diabetes management, and attention to them improves glycaemic control and cardiovascular disease risk, but it is not yet known whether maintained lifestyle changes provide an alternative to drug therapy in the long term.

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Near‐normalization of glycaemic control with glucagon‐like peptide‐1 receptor agonist treatment combined with exercise in patients with type 2 diabetes

Cited by 41 publications

References 41 publications

Effect of exercise combined with glucagon‐like peptide‐1 receptor agonist treatment on cardiac function: A randomized double‐blind placebo‐controlled clinical trial

Effect of exercise combined with glucagon‐like peptide‐1 receptor agonist treatment on cardiac function: A randomized double‐blind placebo‐controlled clinical trial

Physical exercise and non‐insulin glucose‐lowering therapies in the management of Type 2 diabetes mellitus: a clinical review

James Lind Alliance research priorities: should diet and exercise be used as an alternative to drugs for the management of type 2 diabetes or alongside them?

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