Real-world impact on monthly glucose-lowering medication cost, HbA1c, weight, and polytherapy after initiating a GLP-1 receptor agonist

Rose, Tayla N.; Jacobs, Michelle; Reid, Debra J.; Bouwmeester, Carla; Conley, Michael; Fatehi, Borna; Matta, Thomas M.; Barr, Judith T.

doi:10.1016/j.japh.2019.09.001

Cited by 7 publications

(12 citation statements)

References 29 publications

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“…Globally different studies have reported the effect on both weight and glycemic control. [ 12 13 14 15 ] Our results are in line with the findings of these studies. However, recently a study conducted in Saudi Arabia reported no effect of Liraglutide on the weight reduction.…”

Section: Discussionsupporting

confidence: 92%

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Effect of Glucagon-like peptide-1 agonist (liriglutide) on weight and glycemic control among adults with type 2 diabetes mellitus attending primary care center at security forces hospital in Riyadh, Saudi Arabia

Alanazi

Ghoraba

2020

J Family Med Prim Care

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Introduction: Liraglutide is a glucagon-like peptide-1 receptor agonist (GLP-1 receptor agonist), also known as incretin mimetics. This is the new approach for management of weight among diabetic patients along with glycemic controls. The study aims to explore the efficacy of Liraglutide on weight (body mass index) and glycemic control (HbA1C) among adult patients with type 2 diabetes mellitus in primary care center. Methods: Retrospective chart review of 149 adult patients with type II diabetic taking Liraglutide as a monotharepy for 6 months and more were included in the study. Analysis was done in SPSS version 22. Results: Total 149 chart reviews were done. The mean age of participants were 55.52 (SD: 8.167). Of total 58.4% were female and 70% were on insulin. Paired sample statistics reported that pre- and post-change in BMI and weight was significantly different with P value < 0.001. However pre- and post-change in the value of HBA1c was not significantly different with P value 0.561. Conclusion: Through this retrospective study we can conclude that Liraglutide has important effect on weight loss and reduction in BMI. However, further longitudinal studies with large sample size and multi-center randomized controlled trials are needed to generalize the effectiveness of Liraglutide among Saudi population.

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Section: Discussionsupporting

confidence: 92%

“…A recent study with large number of obese female participants with average 10% reported decrease in HbA1c 1.7% (18 mmol/mol) ( P value < 0.001), while overall weight reduces -1.8 kg ( P value 0.001) after the initiation of Liraglutide. [ 12 ]…”

Section: Introduction and Literature Reviewmentioning

confidence: 99%

Effect of Glucagon-like peptide-1 agonist (liriglutide) on weight and glycemic control among adults with type 2 diabetes mellitus attending primary care center at security forces hospital in Riyadh, Saudi Arabia

Alanazi

Ghoraba

2020

J Family Med Prim Care

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“…However, the mean baseline A1c in this study was 10.2%, compared to 9.0% in our population. This is notable as we demonstrated a strong relationship between higher baseline A1c and the degree of A1c decrease, which was also reported by Rose et al 12 Within comparable strata of baseline A1c values, our observations were more similar to Rose et al For example, among patients with a baseline A1c of 10–10.9%, Rose et al reported a mean A1c reduction of −1.9%, where our observed reduction in patients with a baseline A1c ≥ 10% was −1.6% at 6 months following GLP‐1‐RA initiation. This influence of baseline A1c on therapeutic response has been found with both insulin and non‐insulin regimens 14 .…”

Section: Discussionsupporting

confidence: 91%

“…This finding was similar to two previous observational studies, which reported A1c reductions of −0.66% (baseline 8.0%) and −0.7% (baseline 8.7%) at 6 months following GLP‐1‐RA addition to basal‐bolus insulin 10,11 . A third observational study by Rose et al reported a substantially higher mean A1c decrease of −1.8% in patients receiving basal‐bolus insulin at 6–12 months following GLP‐1‐RA initiation 12 . However, the mean baseline A1c in this study was 10.2%, compared to 9.0% in our population.…”

Section: Discussionmentioning

confidence: 53%

“…Several years later, two small controlled trials, with a total sample of just over 100 patients, reported a significant reduction in A1c with the addition of once‐daily liraglutide to basal‐bolus insulin 3,9 . Uncontrolled observational studies have also reported reductions in A1c and weight following the addition of a GLP‐1‐RA to basal‐bolus insulin regimens but have generally involved a small number of sites, totaling less than 250 patients 10‐12 . In 2020, authors published an exploratory subgroup analysis using data from a phase 4, randomized, placebo‐controlled trial of once‐weekly dulaglutide and various insulin therapies in patients with type 2 diabetes in Japan.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Impact of GLP‐1 receptor agonists in veterans receiving basal‐bolus insulin

et al. 2021

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Background In 2017, an estimated 7.4 million Americans used insulin to treat diabetes. Insulin is proven to lower A1c but can result in hypoglycemia and weight gain. Combining insulin with a glucagon‐like peptide‐1 receptor agonist (GLP‐1‐RA) may provide additional blood glucose control while limiting undesirable effects including weight gain. Objective To characterize the clinical impact of adding a GLP‐1‐RA to a basal‐bolus insulin regimen in patients with type 2 diabetes. Methods This retrospective observational study used national Veteran's Health Administration data to identify patients with an existing basal‐bolus insulin regimen who initiated a GLP‐1‐RA between January 1, 2005 and December 31, 2017. A1c, insulin total daily dose (TDD), and weight were collected at GLP‐1‐RA initiation (baseline), 3‐, 6‐, and 12‐month time points and then analyzed using an intent‐to‐treat approach with the last observation carried forward. Decreases in A1c ≥ 0.5% and weight ≥2 kg were deemed clinically significant. Results Among 7651 patients initiating GLP‐1‐RA therapy, mean A1c had a clinically significant decline at 3, 6, and 12 months by −0.5%, −0.7%, and −0.7%, respectively, from a mean baseline of 9%. Patients with lower baseline A1c levels did not have clinically significant changes in A1c, whereas patients with baseline A1c ≥9% had more clinically significant declines. Insulin TDD decreased by −32, −38, and −42 units/day at 3, 6, and 12 months, respectively, where the mean decrease in insulin TDD at 12 months was 79 units/day among patients who discontinued bolus insulin (52.3%) compared with a mean decrease of 2 units/day among those who continued bolus insulin. Mean weight reductions at 3, 6, and 12 months were −1.2, −2.3, and −2.9 kg, respectively, from a mean baseline of 120.6 kg. Conclusion Combining a GLP‐1‐RA with basal‐bolus insulin had a clinically significant improvement on blood glucose control, lowered insulin TDD, and reduced weight. These outcomes were achieved within 3 to 6 months following GLP‐1‐RA initiation and were maintained through 1 year.

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Cost consequence analysis of adding semaglutide to treatment regimen for patients with Type II diabetes in Saudi Arabia

AlRuthia,

Hani Aburisheh,

Ata

et al. 2024

Saudi Pharmaceutical Journal

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Real-world impact on monthly glucose-lowering medication cost, HbA1c, weight, and polytherapy after initiating a GLP-1 receptor agonist

Cited by 7 publications

References 29 publications

Effect of Glucagon-like peptide-1 agonist (liriglutide) on weight and glycemic control among adults with type 2 diabetes mellitus attending primary care center at security forces hospital in Riyadh, Saudi Arabia

Effect of Glucagon-like peptide-1 agonist (liriglutide) on weight and glycemic control among adults with type 2 diabetes mellitus attending primary care center at security forces hospital in Riyadh, Saudi Arabia

Clinical Impact of GLP‐1 receptor agonists in veterans receiving basal‐bolus insulin

Cost consequence analysis of adding semaglutide to treatment regimen for patients with Type II diabetes in Saudi Arabia

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