Effects of glucagon-like peptide 1 receptor agonists on comorbidities in older patients with diabetes mellitus

Onoviran, Olusola F.; Li, Dongming; Smith, Sarah Toombs; Raji, Mukaila A.

doi:10.1177/2040622319862691

Cited by 37 publications

(28 citation statements)

References 118 publications

(255 reference statements)

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“…In addition to glycemic and metabolic benefits, liraglutide is well known for gastrointestinal side effects including nausea, vomiting, and diarrhea [ 20 ]. Most (48%) of the patients in our study also reported nausea.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness, Safety, and Patient Satisfaction of Liraglutide in Type 2 Diabetic Patients

Zameer¹,

Kamin²,

Raja³

et al. 2020

Cureus

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Background and Objectives Liraglutide, an analog of human glucagon-like peptide 1 (GLP-1), has been approved for the treatment of type 2 diabetes mellitus in Pakistan since 2016. It is a GLP-1 receptor agonist that has shown promising results in terms of not only glycemic control but also weight loss. Our study aimed to provide evidence regarding the safety and effectiveness of liraglutide in Pakistan and to look at the adherence rate and treatment satisfaction of patients using liraglutide. Methods This is an observational retrospective study that recruited patients who were treated with liraglutide. Data were collected at the first visit and follow-up. Morisky Green Levine Adherence Scale and Treatment Satisfaction Questionnaire for Medication (TSQM-9) were used for the determination of adherence and satisfaction with the treatment. Results A total of 70 patients were recruited in the study, The mean difference in weight, body mass index, glycated hemoglobin (HbA1C), systolic blood pressure, and diastolic blood pressure from baseline to follow-up was -5.36 kg, -2.14 kg/m 2 , -1.76%, -12.38 mmHg, and 5.55 mmHg, respectively. Nausea was the main side effect reported. TSQM-9 scores were compared from baseline, and it was found that patients are satisfied with the treatment and its effectiveness. Conclusions Our study has demonstrated the effectiveness of liraglutide as a monotherapy or combination therapy in the Pakistani population. Liraglutide led to reduction in HbA1C and weight. This is associated with high treatment satisfaction rate and adherence rate. Thus, liraglutide remains an effective though expensive treatment option in a country like Pakistan.

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Section: Discussionmentioning

confidence: 99%

Effectiveness, Safety, and Patient Satisfaction of Liraglutide in Type 2 Diabetic Patients

Zameer¹,

Kamin²,

Raja³

et al. 2020

Cureus

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“…Also, older patients experienced more hypoglycemic episodes compared to younger patients, which is consistent with observations in a dulaglutide-treated Japanese patient population [ 9 ] and with lixisenatide [ 19 ]. This could be because generally in older patients with T2D aged > 60 years, hypoglycemia is a frequently observed adverse event [ 20 ]. Furthermore, we observed a higher incidence of hypoglycemia in patients taking concomitant SU either as monotherapy or in combination with metformin.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Once Weekly Dulaglutide in East Asian Patients with Type 2 Diabetes: Subgroup Analysis by Potential Influential Factors

Ma¹,

Zhang

Hou

et al. 2020

Diabetes Ther

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Introduction: This subgroup analysis assessed the efficacy and safety of once weekly dulaglutide 1.5 mg and 0.75 mg in East Asian patients with type 2 diabetes (T2D) stratified by key demographic and baseline characteristics. Methods: Change from baseline in glycated hemoglobin (HbA1c), fasting blood glucose (FBG) and body weight were analyzed by age (\ 60 years, C 60 years), gender (male, female), body weight (\ 70 kg, C 70 kg), BMI (\ 25 kg/ m 2 , C 25 kg/m 2), duration of diabetes (\ 10 years, C 10 years), baseline HbA1c (\ 8.5%, C 8.5%) and concomitant oral antihyperglycemic medications (OAMs; metformin only, SU only, metformin ? SU) at week 26 and 52 in East Asian patients from the AWARD-CHN2 study. Incidence of gastrointestinal adverse events (GI AEs) and hypoglycemia was evaluated. Results: A total of 422 East Asian patients with T2D were included in this subgroup analysis. At week 26, the reduction of HbA1c and FBG from baseline were similar across subgroups, except that patients with baseline HbA1c C 8.5% had greater HbA1c and FBG reductions than patients with baseline HbA1c \ 8.5%. Gender analysis showed HbA1c difference that was not clinically significant. The decrease in body weight varied across different subgroups in both dulaglutide doses; however, the difference was not clinically significant. The incidence of GI AEs and total hypoglycemia was generally similar across subgroups in both doses. A similar trend was observed at week 52 in both dulaglutide doses. Conclusions: In East Asian patients with T2D, treatment with dulaglutide (1.5 mg and 0.75 mg) demonstrated significant improvements in glycemic control irrespective of all subgroups, except baseline HbA1c, with greater HbA1c and FBG reductions in patients with higher baseline HbA1c. Dulaglutide was well tolerated with a similar safety profile to other GLP-1 receptor agonists. Trial Registration: ClinicalTrials.gov Identifier: NCT01648582.

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“…GLP-1 binds to GLP-1R in beta-cells of the pancreas to increase insulin secretion and reduce glucagon synthesis. GLP-1R agonists have been shown to reduce hyperlipidaemia, hypertension and fatty liver in diabetic patients [ 29 ]. GLP-1R agonists exenatide, liraglutide and taspoglutide are able to modestly decrease low-density lipoprotein-cholesterol, triglycerides and total cholesterol [ 30 ].…”

Section: Gut Microbiota Metabolites In the Pathogenesis Of Nafldmentioning

confidence: 99%

Gut Microbiota Metabolites in NAFLD Pathogenesis and Therapeutic Implications

Chen¹,

Vitetta

2020

IJMS

184

137

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Gut microbiota dysregulation plays a key role in the pathogenesis of nonalcoholic fatty liver disease (NAFLD) through its metabolites. Therefore, the restoration of the gut microbiota and supplementation with commensal bacterial metabolites can be of therapeutic benefit against the disease. In this review, we summarize the roles of various bacterial metabolites in the pathogenesis of NAFLD and their therapeutic implications. The gut microbiota dysregulation is a feature of NAFLD, and the signatures of gut microbiota are associated with the severity of the disease through altered bacterial metabolites. Disturbance of bile acid metabolism leads to underactivation of bile acid receptors FXR and TGR5, causal for decreased energy expenditure, increased lipogenesis, increased bile acid synthesis and increased macrophage activity. Decreased production of butyrate results in increased intestinal inflammation, increased gut permeability, endotoxemia and systemic inflammation. Dysregulation of amino acids and choline also contributes to lipid accumulation and to a chronic inflammatory status. In some NAFLD patients, overproduction of ethanol produced by bacteria is responsible for hepatic inflammation. Many approaches including probiotics, prebiotics, synbiotics, faecal microbiome transplantation and a fasting-mimicking diet have been applied to restore the gut microbiota for the improvement of NAFLD.

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Effects of glucagon-like peptide 1 receptor agonists on comorbidities in older patients with diabetes mellitus

Cited by 37 publications

References 118 publications

Effectiveness, Safety, and Patient Satisfaction of Liraglutide in Type 2 Diabetic Patients

Effectiveness, Safety, and Patient Satisfaction of Liraglutide in Type 2 Diabetic Patients

Efficacy and Safety of Once Weekly Dulaglutide in East Asian Patients with Type 2 Diabetes: Subgroup Analysis by Potential Influential Factors

Gut Microbiota Metabolites in NAFLD Pathogenesis and Therapeutic Implications

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