Effectiveness and tolerability of liraglutide in patients with type 2 diabetes mellitus and obesity after bariatric surgery

Background: Current guidelines do not offer detailed recommendations on antidiabetic drug therapy in type 2 diabetes (T2D) after bariatric surgery (BS), and reported experience is scarce. Objectives: To evaluate the effectiveness and tolerability of liraglutide at 2 years in patients with morbid obesity after undergoing BS and subsequent relapse, persistence, or new diagnosis of T2D, comparing the results with a cohort of nonsurgical diabetic patients also treated with liraglutide. Setting: Obesity clinic at a University Hospital. Methods: We conducted a retrospective study of 2 cohorts of patients (with and without previous BS) with T2D and obesity who had started treatment with liraglutide at least 2 years before their inclusion in the study. The main outcome measures were the differences in glycated hemoglobin (A1C) and weight at 104 weeks between both groups. Results: A total of 164 patients were included, 15 with previous BS and 149 without BS. Mean baseline parameters were A1C 6.6% and body mass index 40.3 kg/m(2) for the BS group, and A1C 7.5% and body mass index 39.7 kg/m(2) for the non-BS group. At 2 years, A1C and weight were significantly decreased in both groups (BS group: Delta A1C -0.39%, weight -3.4 kg; non-BS group: Delta A1C -0.67%, weight -3.8 kg; all results P < .05), with no significant differences in A1C and weight reduction between both groups. There was a significant lower frequency of withdrawals due to all causes and a nonsignificant lower rate of vomiting and hypoglycemia in patients with BS. Conclusions: Liraglutide achieved a significant reduction in weight and A1C at 2 years in patients with T2D previously treated with BS, showing good gastrointestinal tolerance. (C) 2016 American Society for Metabolic and Bariatric Surgery. All rights reserved.