Insulin tolerance test predicts non response vs. sustained efficacy of Liraglutide on glycemic control in type 2 diabetes patients: A prospective real-world setting study.
Diabetes Res Clin Pract
; 137: 20-27, 2018 Mar.
Article
em En
| MEDLINE
| ID: mdl-29253625
ABSTRACT
AIMS:
Less than half of type 2 diabetes patients treated with Glucagon-Like Peptide 1 (GLP-1) analogs displays good glycemic control, according to real life studies. Predictive markers of inefficacy/efficacy are therefore needed. The effectiveness of Liraglutide in terms of glycemic control and weight loss was then evaluated according to putative predictive parameters.METHODS:
80 type 2 diabetes patients treated with Liraglutide were included in this prospective study. An Insulin Tolerance test (ITT) was performed at baseline to calculate velocity of C-Peptide decrease (C-peptide T½). Several clinical and biological parameters including HbA1c and weight were assessed at baseline and after 12, 24, 52 and 104â¯weeks of treatment.RESULTS:
HbA1c decrease over the follow-up period was highly associated with C-peptide T½. A mean fall of 0.7% of HbA1c (7.7â¯mmol/mol) was predicted with 82% sensitivity and 80% specificity by C-peptide T½. In patients with rapid response during ITT (C-peptide T½â¯<â¯120â¯min), a HbA1c decrease of 1.5% (16.5â¯mmol/mol) was constantly found (pâ¯=â¯.002) all over the follow-up. HbA1c remained unmodified for the rest of the patients (pâ¯=â¯.34) compared to baseline. HbA1c evolution was not predicted by diabetes duration. Weight loss was predicted only by low baseline C-peptide plasma level.CONCLUSIONS:
This study suggests ITT as an efficient test to discriminate non-response from long-term efficacy before initiating Liraglutide. ITT could therefore help avoiding "try and see" prescription pattern by using a more precise and patient-centered strategy in order to reduce inertia in adapting treatment and so reduce subsequent complications.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Hemoglobinas Glicadas
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Diabetes Mellitus Tipo 2
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Liraglutida
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Hipoglicemiantes
Tipo de estudo:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adolescent
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Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Diabetes Res Clin Pract
Assunto da revista:
ENDOCRINOLOGIA
Ano de publicação:
2018
Tipo de documento:
Article