Effect of liraglutide in long-term clinical remission after intensive therapy in newly-diagnosed type 2 diabetes mellitus

Abstract

Objective To observe the effect of liraglutide in the long-term clinical remission after short-term continuous subcutaneous insulin infusion (CSII) in newly diagnosed type 2 diabetes mellitus (T2DM). Methods Eighty-five newly diagnosed T2DM patients from March 2014 to March 2015 in line with the inclusion criteria were discharged after two weeks' CSII intensive therapy. The patients were randomly divided into two groups according to the random number table method: the liraglutide group (40 cases) and the metformin group (45 cases), the patients discontinued drugs after 12 weeks' continuous monotherapy and lifestyle intervention. Fasting plasma glucose (FPG), 2-hours postprandial plasma glucose (2hPG), glycated hemoglobin A1c (HbA1c), body mass index (BMI), fasting C-peptide (FCP), 2-hours postprandial C-peptide (2hCP) and homeostasis model assessment of β cell function (HOMA-β) during the outpatient follow-up visit at 24th week were compared between the two groups. The up-mentioned indexes and clinical remission rate at 48th-week outpatient follow-up were compared between the two groups. The data were compared between the two groups by using t test when equal variance was confirmed with homogeneity test of variances. Results After short-term intensive therapy, the FPG and 2hPG decreased significantly in comparison with those at hospitalization. There was no significant difference between the two groups in age, BMI, duration of disease and other general information. At the 24th week, there was no differences in FPG, HbA1c and BMI between the two groups, the 2hPG was remarkably lower in the liraglutide group than that in the metformin group [(8.4±1.5) vs (11.2±2.2) mmol/L, t=4.26, P<0.05], while the FCP, 2hCP and HOMA-β were significantly lower in the liraglutide group than those in the metformin group [(2.2±0.3) vs (1.8±0.3) μg/L, (4.2±0.7) vs (3.6±0.5) μg/L, 76±7 vs 56±5, t=4.35, 4.70, 6.92, all P<0.05]. The FPG, 2hPG, HbA1c, and BMI were notably lower in the liraglutide group than those in the metformin group at the 48th week [(7.3±1.3) vs (8.1±1.8) mmol/L, (9.5±1.4) vs (11.5±2.1) mmol/L, 6.9%±0.6% vs 7.3%±0.9%, (24.8±1.4) vs (26.2±2.1) kg/m2, t=4.73-6.81, all P<0.05], while FCP, 2hCP and HOMA-β were significantly higher [(2.2±0.4) vs (1.8±0.2) μg/L, (3.9±0.8) vs (3.3±0.5) μg/L, 68±8 vs 50±5, t=9.05, 6.83, 4.92, all P<0.05]. Clinical remission rate was markedly higher in the liraglutide group than that in the metformin group [67.5% (27/40) vs 44.4% (20/45), χ2=4.56, P<0.05]. Conclusion Liraglutide is beneficial in the continuous improvement of pancreatic islet function and long-term clinical remission after intensive therapy in newly-diagnosed T2DM. Key words: Diabetes mellitus, type 2; Liraglutide; Metformin; Intensive therapy