Interindividual differences in the clinical effectiveness of liraglutide in Type 2 diabetes: a real-world retrospective study conducted in Spain.

AIMS: To study the response of clinical variables (HbA1c , body weight, lipid profile and blood pressure) over 24 months of liraglutide treatment in a real-world clinical setting, and to describe the evolution of HbA1c and body weight reduction in response to liraglutide treatment by employing generalized additive mixed models (GAMMs). METHODS: We included people aged ≥ 18 years with Type 2 diabetes mellitus that initiated liraglutide treatment between November 2011 and May 2015. Demographic and clinical data were retrieved retrospectively over 24 months from electronic medical records with a median duration of observation of 7.0 (IQR 3.0-12.0) months. RESULTS: Individuals that initiated liraglutide therapy were obese (BMI 39.1 kg/m2 ), with inadequate HbA1c (68 mmol/mol [8.4%]), blood pressure and lipid levels. Upon liraglutide treatment, HbA1c , body weight, mean systolic and diastolic blood pressure, and lipid levels decreased gradually. GAMMs demonstrated that longer treatment with liraglutide was a predictor of improved HbA1c response, whereas higher baseline HbA1c , longer Type 2 diabetes duration and treatment with insulin were predictors of worse HbA1c response. Higher baseline weight, longer treatment with liraglutide and the interaction between metformin and time were predictors of improved weight response. CONCLUSIONS: In this real-world study, we showed the effectiveness of liraglutide in improving body weight, HbA1c , mean systolic and diastolic blood pressure, and lipid levels. GAMMs indicated that baseline HbA1c and weight, time of treatment with liraglutide, diabetes duration and the use of metformin or insulin are predictors of clinical response to liraglutide.

Prevalence of metabolic syndrome in Galicia (NW Spain) on four alternative definitions and association with insulin resistance.

The present study evaluated the prevalence of the metabolic syndrome (MS) in a representative sample (no.=2860) of adults from the Spanish region of Galicia using the definitions of a) the World Health Organization; b) the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults; c) the European Group for Study of Insulin Resistance; and d) the International Diabetes Federation. In addition, we assess concordance among the different definitions, and the relationships of MS with insulin resistance (IR) as assessed by the homeostatic model assessment (HOMA-IR) index. Our results indicate a high prevalence of MS under all 4 definitions. MS prevalence was higher in men than women on all 4 definitions, and increased significantly with body mass index and age. IR was high among subjects with MS, and the HOMA index was a good discriminator of MS and non-MS on all 4 definitions, suggesting that HOMA index may be a useful predictive tool in clinical practice.