Combination use of liraglutide and insulin to Japanese patients with multiple insulin injection: efficacy and cost.

Abstract

The introduction of liraglutide in the treatment of patients with type 2 diabetes already taking insulin is still subject to discussion in terms of timing and benefits. Gradually intensive insulin therapy is hastily prescribed. Switching from multiple insulin injection (MII) to insulin and liraglutide is evaluated in this study. We studied 92 patients with type 2 diabetes previously under MII, C-peptide ≥ 1.5ng/ml, divided into a group with reasonable glycemic control [RC: HbA1c < 8% (64mmol/mol)] and another with a poor control [PC: HbA1c ≥ 8%, (64mmol/mol)] after introduction of liraglutide and insulin therapy. Except for HbA1c, there were no statistical differences between RC and PC groups. Basal insulin doses were adjusted to achieve the fasting plasma glucose of 90-120mg/dl. HbA1c was significantly improved in both groups, from 9.6% ± 1.6 (81mmol/mol) and 7.0% ± 0.6 (53mmol/mol) to 8.0% ± 1.5 (64mmol/mol) and 6.8 ± 0.5% (51mmol/mol). Reduction of body weight was significant only in RC (from 70 ± 16kg to 68 ± 16kg, p < 0.01). All patients from RC group and 58% of PC group reached HbA1c < 8% without hypoglycemia. This observation persuades us to propose the liraglutide and insulin combination to patients with C-peptide ≥ 1.5ng/ml, regardless of the HbA1c.