Specialized Program for Emerging Adults With Type 1 Diabetes

Abstract

s / Can J Diabetes 36 (2012) S24eS76 S25 Liraglutide can improve glycemic control and facilitate weight loss, but little is known about its effectiveness in patients with diabetic nephropathy or when combined with insulin. We examined the effectiveness of liraglutide added to insulin or oral agents in community diabetic nephropathy prevention clinics in 46 individuals with type 2 diabetes (mean age 55 (30-74) years, diabetes duration 11 7 years, weight 120 29 kg, 20 male). Subjects had stage 1-3 CKD (n1⁄416, 17, 13 for stage 1, 2 and 3 respectively) and median albumin:creatinine ratio was 5.3 (0.3 e 388) mg/mmol. Subjects were taking 1.6 0.7 oral agents and 29 subjects were also taking insulin (129 100 units/day; 1.15 1.02 u/kg/day). Liraglutide treatment was associated with reduced A1c in 80.5%, weight loss in 74% and both in 61% of subjects after 3-6 months. There was no difference between subjects who did or did not take insulin in changes in A1c (-1.1 1.3 v -0.75 0.85%, p1⁄40.3) or weight (-2.2 3.0 v -2.1 2.3kg, p1⁄40.9). Oral diabetes therapy was reduced in 6 (13%) subjects. Themean change in insulin dose was -0.24 0.28 u/kg/day (a 23 21% reduction) with insulin being discontinued in one subject. These data suggest that liraglutide added to insulin or oral agents is an effective agent for improved glycemic control and/or weight loss in type 2 diabetic subjects with nephropathy and earlier stages of chronic kidney disease.