Combination use of liraglutide and insulin to Japanese patients with multiple insulin injection: efficacy and cost
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The introduction of liraglutide in the treatment of patients with type 2 diabetes already taking insulin is still subject to discussion in terms of timing and benefits. Gradually intensive insulin therapy is hastily prescribed. Switching from multiple insulin injection (MII) to insulin and liraglutide is evaluated in this study.
We studied 92 patients with type 2 diabetes previously under MII, C-peptide ≥ 1.5 ng/ml, divided into a group with reasonable glycemic control [RC: HbA1c < 8% (64 mmol/mol)] and another with a poor control [PC: HbA1c ≥ 8%, (64 mmol/mol)] after introduction of liraglutide and insulin therapy.
Except for HbA1c, there were no statistical differences between RC and PC groups. Basal insulin doses were adjusted to achieve the fasting plasma glucose of 90–120 mg/dl. HbA1c was significantly improved in both groups, from 9.6% ± 1.6 (81 mmol/mol) and 7.0% ± 0.6 (53 mmol/mol) to 8.0% ± 1.5 (64 mmol/mol) and 6.8 ± 0.5% (51 mmol/mol). Reduction of body weight was significant only in RC (from 70 ± 16 kg to 68 ± 16 kg, p < 0.01). All patients from RC group and 58% of PC group reached HbA1c < 8% without hypoglycemia.
This observation persuades us to propose the liraglutide and insulin combination to patients with C-peptide ≥ 1.5 ng/ml, regardless of the HbA1c.
KeywordsDiabetes Liraglutide MMI therapy Safety Efficacy C-peptide
This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.
Compliance with ethical standards
Conflict of interest
Matsuda Masafumi MD, Ph.D.: potential competing financial interest and association with commercial entities, cited below, that could be viewed as having an interest in the general area of the submitted manuscript: AstraZeneca Corporation, Sanofi Co., Ltd, Novo Nordisk Pharma Co., Ltd., Takeda Pharmaceutical Co., Ltd., Astellas Pharma Inc., Eli Lilly Co., Ltd., Mitsubishi Tanabe Co., Ltd., Ono Pharmaceutical Co., MSD Corporation, Novartis Pharma Corporation, Japan Boehringer Ingelheim Pharmaceutical Co., Ltd. Sellami-Mnif Houda MD has no competing interests to declare. Toshihiro Umehara MD, Ph.D. has no competing interests to declare. Yamazaki Yuriko MD has no competing interests to declare. Hiroyuki Otake MD, Ph.D. has no competing interests to declare. Tomoko Morita MD, Ph.D. has no competing interests to declare. Matoba Reie MD has no competing interests to declare. Sakashita Anna MD has no competing interests to declare.
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