Although SGLT-2i, DPP-4i, and GLP-1 RAs are recommended as 2nd or 3rd line therapy for type 2 diabetes, important differences exist in the characteristics of users of these drugs. Contrary to existing guidelines, new users of DPP-4i had a higher prevalence of cardiovascular disease at baseline than new users of SGLT2i or GLP-1RA (BMC Endocrine Disorders)
Diabetes News
Tag: GLP-1 RA
De-intensification of basal-bolus insulin regimen after initiation of a GLP-1 RA improves glycaemic control and promotes weight loss in subjects with type 2 diabetes
Replacing prandial insulin with GLP-1 RA is a valuable strategy to simplify the BB insulin regimen while improving glycaemic control and promoting weight loss in subjects with T2D (Acta Diabetologica)
Real-World Treatment Patterns of Glucose-Lowering Agents Among Patients with Type 2 Diabetes Mellitus and Cardiovascular Disease or At Risk for Cardiovascular Disease
Although use of SGLT-2is and GLP-1 RAs increased over time, overall utilization of these agents in patients with T2D and ASCVD/HF or at risk for ASCVD/HF remained low, especially for those aged ≥ 65 years (Diabetes Therapy)
Effectiveness and safety of new oral and injectable agents for in-hospital management of type 2 diabetes in general wards: systematic review and meta-analysis
Our review suggests that inpatient management in the general ward with DPP4i and GLP1Ra is as effective and safe as management with insulin. More randomized studies are required to support these findings before they could be recommended as usual practice (Diabetes Research and Clinical Practice)
Clinical Utility of Cardiovascular Risk Scores for Identification of People With Type 2 Diabetes More Likely to Benefit From Either GLP-1 Receptor Agonist or SGLT2 Inhibitor Therapy
A greater increase in the rate of HHF relative to MACE was observed with progressively higher cardiovascular risk, regardless of the risk score applied. Consequently, SGLT2is may offer greater overall cardiovascular protection in those at highest MACE risk, not just those at highest HHF risk (Diabetes Care)
Association of Glucagon-Like Peptide-1 Receptor Agonist Use With Risk of Gallbladder and Biliary Diseases
This systematic review and meta-analysis of RCTs found that use of GLP-1 RAs was associated with increased risk of gallbladder or biliary diseases, especially when used at higher doses, for longer durations, and for weight loss (JAMA Internal Medicine)
Effect of glucagon-like peptide-1 receptor agonists on renal function: a meta-analysis of randomized controlled trials
Results of our meta-analysis revealed that GLP-1 RA treatment decreases urinary albumin excretion and albumin to creatinine ratio but it did not cause significant changes in creatinine levels and glomerular filtration rate (British Journal of Clinical Pharmacology)
Glucagon-Like Peptide-1 Receptor Agonist Use in People Living with Type 2 Diabetes Mellitus and Chronic Kidney Disease: A Narrative Review of the Key Evidence with Practical Considerations
Here, we review evidence on GLP-1 RA use in people living with T2DM and CKD and summarize renal outcomes from clinical studies. We provide practical considerations for GLP-1 RA use to provide an added benefit to guide treatment in this high-risk patient population (Diabetes Therapy)
Effects of Tirzepatide, a Dual GIP and GLP-1 RA, on Lipid and Metabolite Profiles in Subjects With Type 2 Diabetes
Tirzepatide reduces body weight and improves glycemic control and uniquely modulates metabolites associated with T2D risk and metabolic dysregulation in a direction consistent with improved metabolic health (Journal of Clinical Endocrinology & Metabolism)
Efficacy and safety of liraglutide in type 1 diabetes by baseline characteristics in the ADJUNCT ONE and ADJUNCT TWO randomized controlled trials
In ADJUNCT ONE and ADJUNCT TWO, the efficacy and glycaemic safety of liraglutide did not depend on subgroups, leaving residual beta-cell function as the only identified variable impacting the effect of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) in T1D. These findings support a role for GLP-1 RAs as adjuncts to insulin in T1D, warranting further study (Diabetes, Obesity and Metabolism)
Sodium–Glucose Cotransporter-2 Inhibitors Versus Glucagon-like Peptide-1 Receptor Agonists and the Risk for Cardiovascular Outcomes in Routine Care Patients With Diabetes Across Categories of Cardiovascular Disease
Use of SGLT2 inhibitors versus GLP-1 RAs was associated with consistent reductions in HHF risk among T2D patients with and without CVD, although the absolute benefit was greater in patients with CVD. There were no large differences in risk for MI or stroke among T2D patients with and without CVD (Annals of Internal Medicine)
Efficacy and Safety of Liraglutide in Type 1 Diabetes by Baseline Characteristics in the ADJUNCT ONE and ADJUNCT TWO Randomized Clinical Trials
In ADJUNCT ONE and TWO, the efficacy and glycemic safety of liraglutide did not depend on subgroups, leaving residual beta-cell function the only identified parameter impacting the effect of glucagon-like peptide-1 receptor agonists (GLP-1 RA) in T1D (Diabetes, Obesity and Metabolism)
Heterogeneity amongst GLP-1 RA cardiovascular outcome trials results: can definition of established cardiovascular disease be the missing link?
We conclude that a fair comparison between GLP-1 RA CVOTs would involve post-hoc analysis re-grouping the patients into different cardiovascular risk categories based upon their baseline clinical parameters, in order to even out the criteria used to classify patients (Diabetology & Metabolic Syndrome)
GLP-1 receptor agonists for cardiovascular outcomes with and without metformin. A systematic review and meta-analysis of cardiovascular outcomes trials
Subgroup analyses suggested that treatment with GLP-1 RAs has a beneficial effect on cardiovascular outcomes irrespective of baseline use of metformin. However, given the exploratory nature of subgroup analyses, these findings should be treated as hypothesis-generating rather than conclusive evidence (Diabetes Research and Clinical Practice)
From glucose lowering agents to disease/diabetes modifying drugs: a “SIMPLE” approach for the treatment of type 2 diabetes
Early combination therapy with two and sometimes three of the DMDs (SGLT2i and GLP-1 RA) and metformin, and lower HbA1c targets (< 6.5%), may halt and even regress the pathological basis of diabetes and improve patient’s prognosis (Cardiovascular Diabetology)
Worldwide inertia to the use of cardiorenal protective glucose-lowering drugs (SGLT2i and GLP-1 RA) in high-risk patients with type 2 diabetes
Central to our manifesto is a shift from linear treatment algorithms based on HbA1c target setting to parallel, independent considerations of atherosclerotic cardiovascular disease, heart failure and renal risks, in accordance with newly updated guidelines (Cardiovascular Diabetology)
GLP-1 RA Treatment and Dosing Patterns Among Type 2 Diabetes Patients in Six Countries: A Retrospective Analysis of Pharmacy Claims Data
Across six countries, persistence was highest among DULA patients and generally lowest among exBID patients. ADD/AWD for all GLP-1 RAs was in line with the recommended label. Longer-term data would be useful to obtain a better understanding of GLP-1 RA treatment patterns over time (Diabetes Therapy)
Is It Time to Change the Type 2 Diabetes Treatment Paradigm? Yes!
GLP-1 RAs Should Replace Metformin in the Type 2 Diabetes Algorithm (Diabetes Care)
Occurrence of nausea, vomiting, and diarrhoea reported as adverse events in clinical trials studying glucagon-like peptide-1 receptor agonists: A systematic analysis of published clinical trials
GLP-1 RAs are associated with “gastrointestinal” AEs that are related to dose and background medications (especially metformin), and may vary in a compound-specific manner. Long-acting agents are associated with less nausea and vomiting but more diarrhoea (Diabetes, Obesity and Metabolism)
A meta-analysis comparing clinical effects of short- or long-acting GLP-1 receptor agonists versus insulin treatment from head-to-head studies in type 2 diabetic patients
Slightly better glycaemic control can be achieved by adding GLP-1 RAs to OGLM as compared to insulin treatment, with added benefits regarding body weight, hypoglycaemia, blood pressure and lipoproteins. These differences are in contrast to insulin being prescribed far more often than GLP-1 RAs (Diabetes, Obesity and Metabolism)
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