1800-PUB: The Long-Term Effect of Glucagon-Like Peptide 1 Receptor Agonists on Glycemic Control Is Predominantly Related to Weight Loss

Abstract

Glucagon-like-peptide-1 receptor agonists (GLP-1 RAs) are established treatment options for type 2 diabetes (T2D). In addition to their glycemic benefit, they also induce weight loss by hypothalamic suppression of appetite. However, it is not clear if weight reduction is the main driver for glycemic improvement. We retrospectively evaluated 256 patients with T2D; treated with either exenatide (n=84), dulaglutide (n=99), or semaglutide (n=73) without interruption for 2.5 years. Body weight and A1C were measured every 6 months. Average age was 61.8±11.9 yrs, 51.5% female, diabetes duration 12.9±8.3 yrs, weight 103.1±20.7 kg, BMI 35.7±7.5 kg/m2 and A1C 8.2±1.5%. We classified them collectively and in each medication group into tertiles according to percentage weight loss at 2.5 years. One tertile gained weight and the other 2 lost weight. In the entire cohort, A1C strongly correlated with weight change (p<0.001). The average weight change in each tertile was -12.2±5.7%, -3.5±1.4%, and +2.8±3.4% respectively. The average change in A1C was -0.98±1.8%, -0.56±1.4% and -0.19±1.9 respectively. The same observations were reproducible in each medication group (Figure 1). These data strongly suggest that long-term improvement in glycemic control with GLP-1 RAs is predominantly related to percentage weight loss, and the one third that gained weight had a nonsignificant change in A1C. Disclosure M.Al-badri: None. S.E.Dhaver: None. T.Salah: None. K.Kibaa: None. A.Khater: None. R.Mccarragher: None. L.Demattos: None. F.Al-roomi: None. O.Hamdy: Advisory Panel; Abbott Nutrition, Nemaura Medical, L-Nutra Inc., Twin Health, Consultant; Sanofi, Research Support; Novo Nordisk, Eli Lilly and Company, Gilead Sciences, Inc., Stock/Shareholder; Healthimation.