Efficacy of Liraglutide: GLP 1 Receptor Agonist on Glycemic Control and Weight Loss among Patients with Type 2 Diabetes

Author(s):  
Fatima Jehangir

Background: American Diabetes Association (ADA) made conspicuous changes in its 2019 Standards of Care Diabetes guidelines by choosing Glucagon like Polypeptide 1 (GLP1) receptor agonists and Sodium Glucose co-transporter 2 (SGLT2) inhibitors as the second line treatment options after metformin because both classes of drugs are cardiovascular friendly as proved in the Cardiovascular Outcome Trials (CVOT) trials. GLP analogs show massive weight loss benefits apart from offering good glycemic control. We aimed to determine the impact of liraglutide on correction of hyperglycemia and body weight in Asian population. Methods: A cross sectional pre-post observational study enrolling 49 Type 2 diabetic patients with uncontrolled blood glucose, 15 years and above who agreed to use liraglutide apart from standard care, for glycemic control were recruited in the study. Study site was general practice clinic in Clifton and family medicine health care center Ziauddin University. Pre and post treatment HbA1C and BMI were observed after adding on Liraglutide 1.8 mg to metformin 1 gm bid, over a period of 12 weeks. Differences in the changes in BMI and HbA1C were examined using McNemar’s test. Results: Mean age of the participants was 44.4 years. Duration of Diabetes was 65.1 months i.e. 5.4 years. At week 12, liraglutide 1.8 mg significantly reduced HbA1C levels by 0.94% (8.53+1.07 vs. 7.56+1.04 p-value <0.05) and BMI by 6.2kg (37.23+ 5.3 vs. 31.27.6+5.5 p-value <0.05) statistically significant. Conclusion: Liraglutide 1.8 mg over a period of 12 weeks, significantly reduced body weight (6.2kg p-value 0.05) and improved glycemic control (0.94% p-value<0.05) without causing hypoglycemia.

2021 ◽  
Vol 9 (1) ◽  
pp. 094-103
Author(s):  
Kanyakamon Kunkitikad ◽  
Veerasak Sarinnapakorn ◽  
Chaicharn Deerochanawong ◽  
Sathit Niramitmahapanya ◽  
Navaporn Napartivaumnuay ◽  
...  

Background: The Coronavirus disease 2019 (COVID-19) disease is a pandemic disease spread worldwide and results in lifestyle changes in areas affected by COVID-19. The ongoing social distancing and lockdowns may negatively impact access to medical care and management of type 2 diabetes mellitus (T2DM). Accordingly, we examined the impact of the COVID-19 virus pandemic in Thailand on the glycemic control of patients with T2DM. Method: This study focused on T2DM outpatients at Rajavithi Hospital. Three hundred and fifty participants were included. Baseline characteristics, data on exercise, outdoor activities, and access to foods and blood chemistries, including hemoglobin A1C (A1C) and fasting plasma glucose (FPG), were reviewed, and collected from electronic medical records before and after the COVID-19 pandemic. Results: There was a significant increase in mean A1C (g/L) ± SD (74.8 ± 13.7 vs. 76.0 ± 15.3, p-value <0.016), the mean duration of outdoor activities (hours/day) ± SD during the COVID-19 virus pandemic was significantly decreased. (5.35 ± 4.48 vs. 4.03 ± 4.37, p-value <0.001) Conclusion: The present study showed that mean A1C was significantly increased during the COVID-19 virus pandemic. Nevertheless, a statistical difference was not observed in FPG. The impact of quarantine, social distancing, and community containment during the epidemic on lifestyles may be the essential factor in increasing A1C.


2020 ◽  
Vol 3 (5) ◽  
pp. 01-04
Author(s):  
Abdullah Ghouth

The Background and Purpose: to assess the prevalence of hypertension and micro-vascular complications among type 2 diabetic patients registered in primary health care center in Mukalla city at eastern Yemen. Methods: A Cross-sectional study was conducted in a randomly selected eligible patients from the diabetic registry of the AL Noor Charity Center (ACC), Mukalla city in Yemen. Results: Prevalence of hypertension in the T2DM patients were 46.7% (56/120). Retinopathy is the most micro-vascular complications among the adults having T2DM (73/120, 60.8%) while nephropathy is the least prevalence (13/120, 10.8%), prevalence of neuropathy was 49.2% (59/120). a high prevalence of retinopathy in males (66%) than females (55.7%) and a high prevalence of neuropathy in male adults (52.2%) than females (46%).No statistical significant difference were exit related to gender for any studied complications. Similar findings were observed regarding age related variations. Conclusion: A high prevalence of hypertension, retinopathy and neuropathy were reported among T2DM patients in Mukalla. Adopting effective and safe treatment strategies are highly recommended to prevent premature death and complications due to DM.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A414-A414
Author(s):  
Ibrahim Naoum ◽  
Abedalghani Abedalhalim ◽  
Amir Aker ◽  
Luai Khalaili ◽  
Sameer Kassem

Abstract Background: Diabetes and chronic obstructive pulmonary disease (COPD) are widely prevalent and comorbidity with these diseases is quite common. However, there is limited data on the interrelation between glycemic control and COPD exacerbations in diabetic patients. Objective: To study the association between pre-admission glycemic control and COPD clinical outcomes including mortality, risk of hospital readmission and the need for mechanical ventilation. Methods: A retrospective population-based cohort study. We screened for patients with both diabetes and COPD exacerbation aged 35 years and above. Pre-admission glycemic control was defined by the last HBA1C level prior to hospitalization. Patients with HBA1C&gt;8% were defined as uncontrolled. We evaluated the difference between controlled and uncontrolled groups in the rates of mortality, readmission and the need for mechanical ventilation. We examined demographic and clinical parameters that might reflect COPD severity including: COPD medication use, blood hemoglobin, platelets, LDH and CRP levels. Results: 513 hospitalizations with diabetes and COPD were screened. 222 hospitalization were excluded either due to unestablished diagnosis of COPD or due to lack of HBA1C test in the preceding year. Of the remaining 291, 208 admissions were with controlled diabetes whereas 83 were uncontrolled. Although not statistically significant, the rate of re-hospitalization was higher in the uncontrolled group (OR 1.99, CI 0.99–4.0, p-value 0.051). There was no statistically significant difference in mortality (OR 1.6, CI 0.73–3.5, p-value 0.243). The use of oxygen and the need for noninvasive mechanical ventilation were significantly higher in the uncontrolled group (67.5% vs. 52.4%, p-value 0.019, 33.7% versus 18.8%, p-value 0.006, respectively). There was no significant difference in possible confounders tested between the groups. Conclusion: Uncontrolled diabetes may adversely affect patients with COPD exacerbation. Larger studies are needed to conclusively determine the impact of glycemic control on COPD morbidity and mortality.


Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Soohyun Nam ◽  
Soohyun Nam ◽  
Devon A Dobrosielski ◽  
Kerry J Stewart

Background: Though a high amount of visceral fat is associated with insulin resistance, which can lead to type 2 diabetes (T2D) and cardiovascular diseases (CVDs), less is known about whether lifestyle modification (weight loss diet and exercise) induced changes in visceral fat are associated with improvements in glycemia. Methods: We randomized 77 individuals aged 35-65 years with T2D or pre-diabetes to 6-months of weight loss diet (D); or D combined with supervised moderate-intensity exercise training (D+E). Study measures were total abdominal, visceral and subcutaneous fat volumes by magnetic resonance imaging, aerobic fitness expressed as VO 2 peak during treadmill testing, body mass index (BMI), and HbA1c levels from blood samples. Results: Of 77 subjects (mean age, 54.8±7.8 years; mean BMI, 34.5 ± 4.7 kg/m 2 , women, 77.9%; Whites-65%, Blacks-34%, Asians-1%), n=37 had T2D and n=40 had pre-diabetes. At 6 months, both D and D+E groups improved from baseline (p<0.05 for all) but did not differ in their changes for body weight (D: -6.04 ± 4.54 kg; D+E: -6.68 ± 4.48 kg, p= 0.61 for the group differences in change), abdominal total fat (D: -101.93 ± 68.67 cm 2 ; D+E:-104.16 ± 72.37 cm 2 , p= 0.92), visceral fat (D:-25.53 ± 39.44 cm 2 ; D+E:,-23.24 ± 35.62 cm 2 , p=0.85), HbA1c (D:0.04 ± 0.46%; D+E:0.03 ± 0.63%, p=0.96), and VO 2 peak (D: 2.26 ± 3.92 ml/kg/min ; D+E:3.71 ± 2.65 ml/kg/min, p=0.11). In a multivariate analysis, adjusting for baseline visceral fat, T2D status, body weight loss and increases in aerobic fitness, a reduction in HbA1c (β=-0.49, p =0.007) was associated with a reduction in visceral fat (R 2 =0.34, p=0.02). Conclusion: The key finding was that diet or diet plus exercise-mediated reductions in visceral fat was associated with reduced HbA1c among individuals with T2D or pre-diabetes. These data contribute to growing body of evidence of the benefits of reducing abdominal obesity, in this case, resulting in better glycemic control in T2D and pre-diabetes.


2012 ◽  
Vol 15 (7) ◽  
pp. A494
Author(s):  
C. Mcadam-marx ◽  
B.K. Bellows ◽  
G.D. Wygant ◽  
J. Mukherjee ◽  
S. Unni ◽  
...  

2021 ◽  
Author(s):  
Reem Alqahtani ◽  
Sami Alzahrani ◽  
Moneerah Alhemedi ◽  
Asya Hawsa ◽  
Sarah Idris ◽  
...  

Abstract Objectives:To assess the levels and the associated demographic factors with diabetic self- management (DSM) among diabetic patients in Saudi Arabia. The impact of implementing DSM practices on glycemic control was additionally investigated.Results:The responses of 349 patients were analyzed (51.0% males and 37.2% obese). The median (IQR) raw DSMS score was 187 (165-205). Higher DSMS scores were reported for young adults (aged 20-29 years), insulin users, employed patients, as well as those with normal body mass index values and normal HbA1c results compared to their counterparts. Low HbA1c values were linearly associated with high scores of the healthy eating (β = -0.014, p=0.018) and physical activity subscales (β = 90-0.009, p=0.042).Keywords : Self-management; diabetes; glycemic control; Saudi Arabia.


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