Determinants of response to the glucagon-like peptide-1 receptor agonists in a type 2 diabetes population in the real-world

Abstract

AimsTo identify clinical predictors associated with a response in terms of glycemic control and weight loss in patients with type 2 diabetes treated with glucagon-like peptide-1 receptor agonists (GLP-1RAs). MethodsA retrospective observational study was performed with real-world databases in primary care. Patients with type 2 diabetes-initiated treatment with GLP-1RAs during the study period, and response to GLP-1RAs were determined six months from treatment initiation. An optimal glycated hemoglobin (HbA1c) or weight response was defined as a reduction of ≥ 1% or ≥ 3%, respectively. A “great” response was defined as both an optimal HbA1c and weight response. Bivariate and multivariate analyses with intention-to-treat were performed. ResultsA sample of 2944 patients with type 2 diabetes was recruited. Higher HbA1c at baseline was the main clinical predictor of an optimal HbA1c response (odds ratio [OR]: 2.30, 95% confidence interval [CI]: 1.96–2.71 in men and OR: 2.03, 95% CI: 1.76–2.33 in women). Treatment without insulin at baseline was associated with a greater weight reduction in men (OR: 2.50, 95% CI: 1.41–4.44). Older age and a higher weight at baseline were related with this in women (OR: 1.02, 95% CI: 1.00–1.05 and OR: 1.01, 95% CI: 1.00–1.02, respectively). ConclusionsA high HbA1c at baseline and previous non-insulin therapy were the main predictors of a greater response (optimal HbA1c and weight response) to GLP1ra in both men and women. This may aid in treatment decision-making before initiating treatment with GLP-1RAs.