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Variables associated with HbA1c and weight reductions when adding liraglutide to multiple daily insulin injections in persons with type 2 diabetes (MDI Liraglutide trial 3)

Journal article
Authors S. Dahlqvist
Elsa Ahlén
K. Filipsson
T. Gustafsson
I. B. Hirsch
J. Tuomilehto
Henrik Imberg
B. Ahrén
Stig Attvall
Marcus Lind
Published in BMC Open Diabetes Research and Care
Volume 6
Issue 1
ISSN 2052-4897
Publication year 2018
Published at Department of Mathematical Sciences
Institute of Medicine, Department of Molecular and Clinical Medicine
Language en
Links dx.doi.org/10.1136/bmjdrc-2017-0004...
Keywords HbA1c, liraglutide, predictive variables, weight, hemoglobin A1c, insulin, placebo, proinsulin, abdominal sagittal diameter, add on therapy, adult, Article, blood sampling, body weight loss, controlled study, drug dose reduction, female, follow up, glucose blood level, human, major clinical study, male, medical parameters, middle aged, multicenter study (topic), non insulin dependent diabetes mellitus, priority journal, randomized controlled trial (topic)
Subject categories Endocrinology and Diabetes

Abstract

Objective To evaluate variables associated with hemoglobin A1c (HbA1c) and weight reduction when adding liraglutide to persons with type 2 diabetes treated with multiple daily insulin injections (MDI). Research design and methods This was a reanalysis of a previous trial where 124 patients were enrolled in a double-blind, placebo-controlled, multicenter randomized trial carried out over 24 weeks. Predictors for effect on change in HbA1c and weight were analyzed within the treatment group and with concurrent interaction analyses. Correlation analyses for change in HbA1c and weight from baseline to week 24 were made. Results The mean age at baseline was 63.7 years, 64.8% were men, the mean number of insulin injections was 4.4 per day, the mean daily insulin dose was 105 units and the mean HbA1c was 74.5 mmol/mol (9.0%). The mean HbA1c and weight reductions were 12.3 mmol/mol (1.13%; P<0.001) and 3.8 kg (P<0.001) greater in liraglutide than placebo-Treated persons. There was no significant predictor for greater effect on HbA1c that existed in all analyses (univariate, multivariate and interaction analyses against controls). For a greater weight reduction when adding liraglutide, a lower HbA1c level at baseline was a predictor (liraglutide group P=0.002, P=0.020 for liraglutide group vs placebo). During follow-up in the liraglutide group, no significant correlation was found between change in weight and change in HbA1c (r=0.09, P=0.46), whereas a correlation existed between weight and insulin dose reduction (r=0.44, P<0.001). Conclusion Weight reduction becomes greater when adding liraglutide in patients with type 2 diabetes treated with MDI who had a lower HbA1c level compared with those with a higher HbA1c level. There was no correlation between reductions in HbA1c and weight when liraglutide was added, that is, different patient groups responded with HbA1c and weight reductions. Trial registration number EudraCT nr: 2012-001941-42. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

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