Effects of Liraglutide Combined with Short-Term Continuous Subcutaneous Insulin Infusion on Glycemic Control and Beta Cell Function in Patients with Newly Diagnosed Type 2 Diabetes Mellitus: A Pilot Study.

Weijian Ke,Xiaopei Cao,Haipeng Xiao,Liehua Liu,Juan Liu,Jianbin Liu,Zhihong Liao,Wanping Deng,Pengyuan Zhang,Yanbing Li,Ailing Chen

doi:10.1155/2016/6839735

Abstract

The objective of this paper is to investigate the effects of liraglutide in combination with short-term continuous subcutaneous insulin infusion (CSII) therapy on glycemic control and beta cell function in patients with newly diagnosed type 2 diabetes mellitus (T2DM). Thirty-nine eligible newly diagnosed T2DM patients were recruited and randomized to receive either of two therapies: short-term CSII alone (CSII alone group) or CSII in combination with liraglutide (CSII + Lira group) for 12 weeks. Blood glucose control, homeostasis model assessment (HOMA) indices, and acute insulin response (AIR) were compared between the two groups. The patients in CSII + Lira group achieved euglycemia with equivalent insulin dosage in shorter time (1 (0) versus 2 (3) days, P = 0.039). HbA1c at the end of study was comparable between two groups (6.3 ± 0.7% versus 6.0 ± 0.5%, for CSII alone group and CSII + Lira group, resp., P = 0.325). The increment of AIR was higher in CSII + Lira group (177.58 (351.57) μU·min/mL versus 58.15 (51.30) μU·min/mL, P < 0.001). However, after stopping liraglutide, its effect on beta cell function disappeared completely. Liraglutide combined with short-term CSII was effective in further improving beta cell function, but the beneficial effects did not sustain after suspension of the therapy.

Highlights

Diabetes mellitus is the most common metabolic disease and becomes a heavy burden of public health systems
The therapy, which lasted for only 2-3 weeks, had its limitations in covering the multiple pathophysiological defects in the long term. In another trial investigating the effect of combination of metformin or rosiglitazone with continuous subcutaneous insulin infusion (CSII), the combination of metformin for 3 months had better effects on insulin secretion function measured by acute insulin response (AIR) and homeostasis model assessment (HOMA)-B while the combination with rosiglitazone better improved muscle insulin resistance [7]
Since the two medicines used in that study mainly were targeted at insulin resistance, it would be of great interest whether combining CSII with medicine Journal of Diabetes Research intervening beta cell failure, the critical pathophysiology mechanism of type 2 diabetes mellitus (T2DM), might provide better clinical outcomes compared with short-term CSII alone

Summary

Introduction

Diabetes mellitus is the most common metabolic disease and becomes a heavy burden of public health systems. Deterioration of beta cell function and insulin resistance are two fundamental pathophysiologic defects of type 2 diabetes mellitus (T2DM). The therapy, which lasted for only 2-3 weeks, had its limitations in covering the multiple pathophysiological defects in the long term. In another trial investigating the effect of combination of metformin or rosiglitazone with CSII, the combination of metformin for 3 months had better effects on insulin secretion function measured by acute insulin response (AIR) and HOMA-B while the combination with rosiglitazone better improved muscle insulin resistance [7]. Since the two medicines used in that study mainly were targeted at insulin resistance, it would be of great interest whether combining CSII with medicine

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