Liraglutide as additional treatment for type 1 diabetes

Objective: To determine whether the addition of liraglutide to insulin to treat patients with type 1 diabetes leads to an improvement in glycemic control and diminish glycemic variability. Subjects and methods: In this study, 14 patients with well-controlled type 1 diabetes on continuous glucose monitoring and intensive insulin therapy were treated with liraglutide for 1 week. Of the 14 patients, eight continued therapy for 24 weeks. Results: In all the 14 patients, mean fasting and mean weekly glucose concentrations significantly decreased after 1 week from 130 ± 10 to 110 ± 8 mg/dl (P<0.01) and from 137.5 ± 20 to 115 ± 12 mg/dl (P<0.01) respectively. Glycemic excursions significantly improved at 1 week. The mean S.D. of glucose concentrations decreased from 56 ± 10 to 26 ± 6 mg/dl (P<0.01) and the coefficient of variation decreased from 39.6 ± 10 to 22.6 ± 7 (P<0.01). There was a concomitant fall in the basal insulin from 24.5 ± 6 to 16.5 ± 6 units (P<0.01) and bolus insulin from 22.5 ± 4 to 15.5 ± 4 units (P<0.01). In patients who continued therapy with liraglutide for 24 weeks, mean fasting, mean weekly glucose concentrations, glycemic excursions, and basal and bolus insulin dose also significantly decreased (P<0.01). HbA1c decreased significantly at 24 weeks from 6.5 to 6.1% (P=0.02), as did the body weight by 4.5 ± 1.5 kg (P=0.02). Conclusion: Liraglutide treatment provides an additional strategy for improving glycemic control in type 1 diabetes. It also leads to weight loss.