Long-Term Effectiveness of Liraglutide for Weight Management and Glycemic Control in Type 2 Diabetes

Abstract

Background: Liraglutide is the first glucagon-like peptide-1 receptor agonist (GLP-1 RA) based on the human GLP-1 sequence, with potential weight loss benefits, approved for the treatment of type 2 diabetes (T2D) mellitus. Herein, we aimed to assess the 5-year effectiveness of Liraglutide in the management of weight and glycometabolic control in a Southern Italian cohort of overweight/obese T2D patients, who were naïve to GLP-1 RAs. Patients and Methods: Forty overweight or obese patients treated with Liraglutide at doses up to 1.8 mg/day, in combination with one or more oral antidiabetic agents, were retrospectively assessed at baseline, during, and after 60 months of continuous therapy. Results: After 5 years of Liraglutide treatment, body weight decreased from 92.1 ± 20.5 kg to 87.3 ± 20.0 Kg (p < 0.001), with a mean reduction of 5.0 ± 7.0 Kg and a body mass index (BMI) decrement of −2.0 ± 3.1 Kg/m2. On Spearman’s univariate analysis, change in body weight was correlated with female gender and baseline BMI. Hemoglobin A1c (HbA1c) decreased from 7.9 ± 0.9% at baseline to 7.0 ± 0.7% at the end of the study period (p < 0.001), followed by a significant reduction in fasting plasma glucose. No significant differences emerged in other biochemical parameters, despite a trend toward improvement in lipid profile. Notwithstanding encouraging effects on several markers of cardiovascular disease (CVD), increments in the 5- and 10-year risk for the first atherosclerotic cardiovascular event were documented, as four incident cases of myocardial infarction. Conclusions: Prolonging treatment with Liraglutide can lead to durable benefits in relation to weight and glycemic control, with a greater impact on women. These results extend and corroborate previous observations, suggesting that gender per se may modulate the response to Liraglutide. Despite favorable effects on some established CVD risks factors, the long-term role of Liraglutide in primary prevention of CVD in patients with T2D remains controversial.

Mediterranean Diet Nutrients to Turn the Tide against Insulin Resistance and Related Diseases

“…In addition, marked gender differences were observed in response to the MedDiet in this study, with reduced SBP in males, and decreased arterial stiffness, but not peripheral BP, in females, which agrees with arterial structure dimorphisms and hormonal influences on BP [39]. However, discrepancies in CVD effects of nutritional interventions, may also arise from gender-specific pharmacokinetics of phenolic compounds contained within foods and dietary supplements [197], which is similar to that of cardiovascular-protective antidiabetic drugs [53]. Although the CVD influence of the MedDiet is mediated by the combination of different foods and healthy lifestyle habits, some specific polyphenol-rich dietary components might be more effective than others in modulating BP and conferring vasoprotection, particularly on a background of IR.…”

“…Additionally, the dose-response analysis suggested a 5% reduction of T2D risk for each 300 mg/day increment of total flavonoids intake [59]. With regard to flavonoid subclasses, a beneficial effect in reducing the risk of T2D was significant for anthocyanidins, flavan-3-ols, flavonols, and isoflavones, but not for other subclasses, suggesting that different bioactive molecular pathways may be triggered by these nutrient compounds in relation to From a diabetes prevention perspective, the GLP-1-releasing effects of PUFAs could be particularly important, given that obese patients have lower GLP-1 responses to oral glucose than individuals of normal weight, irrespective of the glycemic status [52,53]. Nonetheless, a large meta-analysis of controlled trial, has recently evidenced that dietary supplementation with PUFAs may have little or no effect on TD2 prevention, or measures of IR, in at-risk patients [54].…”

“…Although surgical and pharmacological strategies [12] have been shown to be useful, energy reduced diets, as part of a healthy lifestyle, may almost invariably facilitate weight loss and reduce IR in these patients [13]. Even a moderate weight loss of only 5%-10% can lead to several health advantages in obese individuals, which include improvement in cardiometabolic parameters, reduction of blood From a diabetes prevention perspective, the GLP-1-releasing effects of PUFAs could be particularly important, given that obese patients have lower GLP-1 responses to oral glucose than individuals of normal weight, irrespective of the glycemic status [52,53]. Nonetheless, a large metaanalysis of controlled trial, has recently evidenced that dietary supplementation with PUFAs may have little or no effect on TD2 prevention, or measures of IR, in at-risk patients [54].…”

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

“…In Italy, a cohort of 400 patients was prescribed with liraglutide and showed a significant positive determinant for HbA1c reduction after a follow-up of 12 months [ 14 ]. Another study reported HbA1C levels decreased from 7.9 ± 0.9% at baseline to 7.0 ± 0.7% after five years of liraglutide treatment [ 15 ]. Fasting plasma glucose (FPG) was also reported to have significant reduction.…”

A Partial Phenotype of adFNDI Related to the Signal Peptide c.55G>A Variant of the AVP Gene

“…To the best of our knowledge, this is the first report of adFNDI specifically involving a kindred of Calabria, which is regarded as a Mediterranean region with a highly homogeneous genetic population structure [21,22]. In the last few decades, the Calabrian population has been a resource for genetic research because of its historical isolation and increased prevalence of progressive neurodegenerative disorders, inherited as Mendelian traits [23].…”