Abstract
Background: Hyperglycemia in type 2 diabetes causes glucotoxicity, which can be treated with intensive insulin therapy. However, this treatment can lead to weight gain and hypoglycemia. The present study investigated the efficacy and safety of combination therapy with liraglutide and insulin glargine as the initial treatment for patients with moderate or severe hyperglycemia. Methods: Changes in clinical indexes such as glycated hemoglobin (HbA1c) and body mass index (BMI) were retrospectively investigated in 20 patients under combination therapy with liraglutide and insulin glargine and 10 patients treated with intensive insulin therapy. Results: Combination therapy with liraglutide and insulin glargine significantly improved HbA1c and BMI at 3 months compared with baseline. However, BMI was not improved in patients treated with intensive insulin therapy. Severe hypoglycemia was not observed in the combination therapy group during the observation period, and no patients required switching because of gastrointestinal symptoms. Conclusion: Combination therapy with liraglutide and insulin glargine demonstrated a superior glucoselowering effect, safety, and convenience without increasing body weight in poorly controlled patients with type 2 diabetes under hyperglycemic conditions. These results suggest that combination therapy could be considered an alternative to intensive insulin therapy.
Highlights
Type 2 diabetes is a progressive disease that creates a vicious cycle of glucotoxicity, and it is important to break the cycle and normalize glucose metabolism by initiating early treatment
Combination therapy with liraglutide and insulin glargine significantly improved HbA1c and body mass index (BMI) at 3 months compared with baseline
Combination therapy with liraglutide and insulin glargine demonstrated a superior glucoselowering effect, safety, and convenience without increasing body weight in poorly controlled patients with type 2 diabetes under hyperglycemic conditions. These results suggest that combination therapy could be considered an alternative to intensive insulin therapy
Summary
Type 2 diabetes is a progressive disease that creates a vicious cycle of glucotoxicity, and it is important to break the cycle and normalize glucose metabolism by initiating early treatment. Intensive insulin therapy with multiple insulin injections is considered effective for removing the glucotoxicity caused by hyperglycemia [1], and such removal has been performed in many patients with hyperglycemia under hospitalization and frequent self-monitoring of glucose. Glucagon-like peptide-1 (GLP-1) receptor agonists are type 2 diabetes drugs that can be used in combination with insulin therapy and contribute to the improvement of fasting blood glucose levels, and postprandial blood glucose levels. Combined use of a GLP-1 receptor agonist with insulin,which mainly improves fasting blood glucose levels may enable better glycemic control [2]. The clinical effects of such combination therapies with simultaneous initiation of both drugs as the initial treatment have not been fully investigated
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