A recent meta-analysis suggests that the glucagon-like peptide-1 receptor agonist (GLP-1RA) liraglutide (marketed as Victoza) produces modest reductions of HbA1c levels with significant weight loss as well as small insulin dose reductions in type 1 diabetes.
Previous small-scale studies, including the phase III clinical trials ADJUNCT 1 and ADJUNCT 2, showed that the effect on HbA1c with liraglutide was either inconsequential or that the magnitude of the fall in HbA1c levels was dose-dependent and inconsistent.
This new meta-analysis, led by a research group at the University of Buffalo (NY), expanded upon the ADJUNCT findings with data from 212 participants involved in three randomised controlled trials on GLP-1RAs in type 1 diabetes, including liraglutide.
The findings, presented at the American Association of Clinical Endocrinologists annual meeting, highlighted a 3.16 mmol/mol reduction in HbA1c readings after 12 weeks of treatment with Victoza or Saxenda, the rebranded weight loss version of Victoza.
In addition to lowering HbA1c levels, liraglutide as an add-on to insulin reduced body weight by about 5 kg and resulted in small insulin dose reductions, equal to a 4.39 and 2.55 drop in units of daily bolus insulin and daily basal insulin, respectively.
There was no reported increase in the incidence of hypoglycemia between the liraglutide and control groups. However, more side effects such as gastrointestinal issues and nausea were observed with liraglutide.
The initial consensus after publication of the findings from the ADJUNCT trials last year was that the results obtained with liraglutide weren’t enough to justify its use for patients with type 1 diabetes.
Yet, this new review of evidence tends to suggest that liraglutide can have small but measurable benefits for people with type 1 diabetes, especially for those who are unable to reduce their HbA1c enough to lessen their risks of common complications.
However, further clinical trials over longer periods should be conducted to establish the durability and consistency of effects of liraglutide on blood sugar control in type 1 diabetes.
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