19. Efficacy and Safety of Liraglutide Added to Insulin in Type 1 Diabetes: The LIRA-1 Trial (277-OR)

Abstract

Weight gain and hypoglycemia are common side effects to insulin therapy in type 1 diabetes (T1D). The combination of insulin and glucagon-like peptide-1 receptor agonist (GLP-1RA) therapy has proven effective in reducing weight gain and insulin dose in type 2 diabetes. This 26-week trial is the first randomized, double-blinded, placebo controlled study to evaluate efficacy and safety of GLP-1RA treatment in poorly controlled, overweight patients with T1D. One hundred patients with T1D, HbA1c > 64 mmol/mol and BMI > 25 kg/m2, were randomized to liraglutide 1.8 mg (LIRA) or placebo added to intensive insulin therapy. Mean baseline characteristics were similar between groups (LIRA; placebo ± SD) age 47 ± 13; 49 ± 12 years, HbA1c 73 ± 8;73 ± 8 mmol/mol, daily insulin dose 75 ± 30; 74 ± 26 IU/day and body weight 93.4 ± 14.2; 94.0 ± 12.5 kg except diabetes duration 20 ± 12; 25 ±12 years. After 12 weeks, LIRA reduced HbA1c, body weight and daily insulin dose compared with placebo. At end of treatment no difference in HbA1c between groups was found. Body weight and daily insulin dose remained reduced in the LIRA group. Frequency of hypoglycemia did not differ between groups. Nausea occurred more frequently with LIRA than placebo (48% vs. 7%). In conclusion, LIRA added to insulin treatment reduced body weight and daily insulin dose in overweight, poorly controlled patients with T1D, but did not improve HbA1c compared with placebo at end of treatment.