Efficacy and safety of liraglutide versus sitagliptin in obese patients with inadequately controlled type 2 diabetes with insulin therapy

Abstract

Objective To investigate the efficacy and safety of liraglutide versus sitagliptin in obese patients with inadequately controlled type 2 diabetes with insulin therapy. Methods Ninety-eight cases of type 2 diabetic with body mass index(BMI)>25 kg/m2, waist circumference(male>90 cm and female> 85 cm), glycated hemoglobin A1c(HbA1c) 7.5%-9.5% were enrolled from February 2013 to February 2014 in Quanzhou First Hospital Affiliated to Fujian Medical University. All subjects who received metformin (at least 1 000 mg/d) and insulin (at least 45 U/d) for at least 6 months were numberally randomly assigned to receive additional liraglutide (0.6 mg for one week followed by 1.2 mg later) once a day (n=48) or sitagliptin 100 mg once a day(n=50) in a 16-week study. Participants were evaluated for glycaemic control, weight, blood pressure, lipid profiles, and adverse events at baseline and 16 weeks. Paired t test was used to analyze changes within groups. Two-sample t test was applied to compare differences of continuous variables between groups. Rates were compared by using the Chi-Square test. Results Compared to the baseline, after 16-week treatment, the HbA1c decreased for 1.4%±0.4% in liraglutide group and for 1.2%±0.4% in sitagliptin group(t=2.5, P 0.05). After 16-week treatment, weight loss for (2.5±2.4) kg was observed in the liraglutide group, while weight gain was reported in the sitagliptin group for (0.3±1.2) kg(t=6.8, P 0.05). The incidence of gastrointestinal adverse events was greater in the liraglutide group than that in sitagliptin group. Conclusions Liraglutide and sitagliptin applied to patients with inadequately glycemic controlled and obese type 2 diabetes with insulin therapy can beneficial to regulate glucose. Liraglutide is superior on glucose control and drop of weight and systolic blood pressure to sitagliptin. Stagliptin leads to fewer gastrointestinal effects than liraglutide. Key words: Diabetes mellitus, type 2; Obesity; Insulin; Liraglutide; Stagliptin