Abstract
Purpose: To compare the effectiveness of glucagon-like peptide 1 receptor agonist with that of basal insulin in type 2 diabetes patients.
 Methods: Type-2 diabetes patients who were insensitive to metformin were treated with glucagon-like peptide 1 receptor agonist (GP cohort, n = 115) or basal insulin (BI cohort, n = 152) with metformin. Hemoglobin A1c (HbA1c) level and body weight were determined, and adverse effects also recorded.
 Results: After 16 weeks of treatment, glucagon-like peptide 1 receptor agonist did not significantly reduce HbA1c levels (7.45 ± 2.11 % vs. 7.01 ± 2.01, p = 0.107). In contrast, basal insulin significantly reduced the levels of HbA1c (7.91 ± 2.98 % vs. 7.13 ± 2.22 %, p = 0.010, q = 3.852). Glucagon-likepeptide 1 receptor agonist reduced the body weight of patients (65.25 ± 7.55 kg vs. 62.16 ± 6.15 kg, p = 0.0008, q = 5.121), unlike basal insulin (63.71 ± 6.15 vs. 62.65 ± 6.76 kg, p = 0.154).
 Conclusion: Glucagon-like peptide 1 receptor agonist and basal insulin + metformin produce identical effectiveness in the treatment of type-2 diabetic patients.
 Keywords: Glucagon-like peptide-1 receptor agonist, Glycemic control, Insulin, Metformin, Type-2 diabetes
Highlights
It has been estimated that type-2 diabetes is prevalent in 11.6 % of the population of China, with 3000 new patients per day [1]
After 4 months of treatment with glucagon-like peptide 1 receptor agonist, there were no decreases in Hemoglobin A1c (HbA1c) levels (7.45 ± 2.11 % vs. 7.01 ± 2.01, p = 0.107), but basal insulin treatment reduced HbA1c levels (7.91 ± 2.98 % vs. 7.13 ± 2.22 %, p = 0.010, q = 3.852)
The results obtained in this study have demonstrated that glucagon-like peptide 1 receptor agonist and basal insulin reduce HbA1c and body weight of type-2 diabetic patients after 32 weeks of combined treatment with metformin, with manageable treatment-emergent adverse effects
Summary
It has been estimated that type-2 diabetes is prevalent in 11.6 % of the population of China, with 3000 new patients per day [1]. Diabetic patients have higher chances of developing complications, comorbidity, morbidity, and mortality than non-diabetic persons [2]. Many diabetic patients are unable to achieve glycemic control due to the failure of oral hypoglycemic agents [3]. Studies on several hypoglycemic agents e.g. sulfonylureas, insulin, glucagon-like peptide 1 receptor agonists, dipeptidyl peptidase 4 inhibitors, and their combinations have revealed consistent ineffectiveness in glycemic control [4]. The first drug of choice for type 2 diabetes patients is metformin. When metformin is not effective, other hypoglycemic agents are added for management of hyperglycemia [5]. Glucagon-like peptide 1 receptor agonists improve glucose homeostasis
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