LIRAGLUTIDE AS ADDITIONAL TREATMENT TO INSULIN IN OBESE PATIENTS WITH TYPE 1 DIABETES MELLITUS

Objective: Because approximately 40% of patients with type 1 diabetes have the metabolic syndrome, we tested the hypothesis that addition of liraglutide to insulin in obese patients with type 1 diabetes will result in an improvement in plasma glucose concentrations, a reduction in hemoglobin A1c (HbA1c), a fall in systolic blood pressure, and weight loss. Methods: This is a retrospective analysis of data obtained from 27 obese patients with type 1 diabetes treated with liraglutide in addition to insulin. Patients were also treated for hypertension. Paired t tests were used to compare the changes in HbA1c, insulin doses, body weight, body mass index, 4-week mean blood glucose concentrations (28-day insulin pump mean blood glucose), blood pressure, and lipid parameters prior to and 180 +/- 14 days after liraglutide therapy. Results: Mean glucose concentrations fell from 191 +/- 6 to 170 +/- 6 mg/dL (P = .002). HbA1c fell from 7.89 +/- 0.13% to 7.46 +/- 0.13% (P = .001), without an increase in frequency of hypoglycemia. Mean body weight fell from 96.20 +/- 3.68 kg to 91.56 +/- 3.78 kg (P < .0001). Daily total and bolus doses of insulin fell from 73 +/- 6 to 60 +/- 4 (P = .008) units and from 40 +/- 5 to 29 +/- 3 units (P = .011), respectively. Mean systolic blood pressure fell from 130 +/- 3 to 120 +/- 4 mm Hg (P = .020). Conclusion: Addition of liraglutide to insulin in obese patients with type 1 diabetes mellitus leads to improvements in glycemic control and HbA1c and to reductions in insulin dose, systolic blood pressure, and body weight.