THU285 Predictive Factors Of Response To Liraglutide In Long-standing Type 2 Diabetes: A Real-life Study

Abstract

Abstract Disclosure: F. Romero: None. D. Ferreira: None. M. Rodriguez: None. C. Escurra: None. A. Muller: None. R. Rodriguez: None. E. Valinotti: None. Introduction: Liraglutide demonstrated efficacy, safety and cardioprotective effects in DM2 in RCT and real-life studies. Benefits across diverse spectrum of patients, but the degree of HbA1c improvement differs within groups with different demographics and clinical characteristics.Objectives: To evaluate the effect of the addition of liraglutide on metabolic control and weight in patients with DM2 treated with oral antidiabetics (OADS) and/or insulin, who do not achieve good control and to identify predictive factors for a greater decrease in HbA1c.Materials and methods: Prospective study, at the Endocrinology Service of the Social Security Institute in 2019, which included patients with DM2 and HbA1c greater than 7%, on treatment with OADS, basal insulin ± OADS or basal/bolus insulin ± OADS, in who were added liraglutide 1.8 mg/day SC. At 6 months, the reduction in HbA1c and body weight was evaluated.Results: 103 patients with DM2 of 59.6 ± 10 years old, 66.3% women and 12.5 ± 6 years of duration of DM2 were included. 18.3% treated only with OADS and 81.7% with insulin (47.1% basal insulin ± OADS and 34.6% basal/bolus insulin ± OADS) initial weight 99.1 ± 23.5 kg, BMI 37.4 ± 8.2 kg/m2, basal glycemia 182.7 ± 65 mg/dl and HbA1C 9.2 ± 1.6%. At 6 months of addition of liraglutide, weight loss of 3.2 ± 3.8 kg, 23.12% decreased > 5%, and 5.8% > 10%. The decrease in HbA1c was 1.1 ± 1.3%, 58.7% decreased > 1%, and 21.2% > 2%, the final glycemia was 145.7 ± 52.3 mg/dl. 38% managed to suspend insulin (basal 8.3%, rapid 10.9%) or reduce the dose of basal insulin (10%). The initial mean values were compared: age, years of DM duration, weight, BMI, glycemia and HbA1c among the patients who achieved a reduction of 1 or more % of HbA1c, finding significant differences for initial BMI (p 0.02), basal glycemia (p 0.010), initial HbA1c (p 0.022). In addition, the proportions of patients in terms of sex, different initial treatment groups and weight reduction were compared, and a significant difference was observed only in the latter (p 0.036). Conclusion: In this study of patients with long-standing diabetes, mostly treated with insulin and poor metabolic control, the addition of liraglutide achieved a reduction in HbA1C of 1% or more in almost two thirds, especially in those with higher initial values of BMI, glycemia and HbA1c and in those who achieved weight reduction. An important group achieved the suspension or reduction of the insulin dose. Presentation: Thursday, June 15, 2023