Use of flash glucose-sensing technology in patients with type 2 diabetes treated with liraglutide combined with CSII: a pilot study

Abstract

Glycemic variability (GV) may be linked to the development of diabetic complications by inducing inflammation, oxidative stress, and endothelial dysfunction. Flash glucose monitoring (FGM) provides a novel method of continuously monitoring interstitial glucose levels for up to 14 days. This study randomly assigned poorly controlled type 2 diabetes mellitus patients treated with metformin and multiple daily injections of insulin (n=60) to either continuous subcutaneous insulin infusion (CSII) treatment or CSII in combination with liraglutide (CSII+Lira) treatment for 14 days during hospitalization. GV was assessed using a FGM system; weight and cardiometabolic biomarkers were also evaluated. The coefficient of variation was significantly reduced in the CSII+Lira group (P<0.001), while no significant change was observed in the CSII group. The changes differed significantly between the two groups in mean amplitude of glycemic excursions (P=0.004), standard deviation (P=0.006), and the percentage of time in the target range (4–10 mmol/L, P=0.005 and >10 mmol/L, P=0.028). The changes in mean of daily differences, interquartile range, and percentage of time in hypoglycemia (<3.3 mmol/L) and hyperglycemia (>13.9 mmol/L) identified by FGM showed no difference. Treatment with liraglutide increased serum adiponectin [33.5 (3.5, 47.7) pg/mL, P=0.003] and heme oxygenase-1 levels [0.4 (–0.0, 1.8) ng/mL, P=0.001] and reduced serum leptin levels [–2.8 (3.9) pg/mL, P<0.001]. Adding the glucagon-like peptide-1 analog liraglutide improved GV, weight, and some cardiometabolic risk markers. The FGM system is, therefore, shown to be a novel and useful method for glucose monitoring.

Glucagon‐like peptide‐1 receptor agonists improve biomarkers of inflammation and oxidative stress: A systematic review and meta‐analysis of randomised controlled trials

“…They comprised 6749 patients (inflammation evaluated in 6560, oxidative stress in 701 patients), included a median (IQR) study population of 60 (33‐122) participants, and had a median (IQR) follow‐up of 6 months (84‐182 days). Trials recruited from 11 individual countries and were multinational in four cases (14 from China, 30–33,37–39,41,44,47,48,56,58,65 seven from the United States, 36,52,53,59,61,63,68 three international studies, 46,64,66 three from Italy, 49,62,67 three from Japan, 45,55,57 two from Denmark, 50,69 two from Greece, 42,54 two Sweden, 34,35 one from France, 51 one from Germany, 60 one from India, 40 and one from Spain 43 ). Participants had a mean age of 53.1 years, 56.3% were women, the mean HbA1c was 55.6 (±8.89) mmol/mol, the mean BMI was 28.8 (±3.52) kg/m 2 .…”

“…Participants had T2DM (39 trials) or prediabetes (three trials), and had a mean diabetes duration of 7.46 (±4.22) years (Table 1). In 16 studies (20.8% of total participants), both the active and control arms were also receiving concomitant metformin, 33,35,40,43,45,48,50–54,61–63,65,67 whereas the presence of concomitant medications was not clear in 11 studies (25.2% of total participants) 30,32,36,38,39,44,47,56–58,64 . In three studies (5.8% of total participants) >50% of participants received concomitant metformin and other diabetes medications 45,51,61 .…”

The relationship between different C-peptide level and insulin dose of insulin pump

“…Early intensive treatment can quickly control blood glucose levels, reduce the severity of glucotoxicity, and recover the islet function in varying degrees 2 , 3 . Thus, due to precise and flexible dosage adjustment, the insulin pump can quickly control the blood glucose, reduce insulin dosage, and reduce the occurrence of hypoglycemia, which is an important means of intensive insulin therapy 4 . The impact of the diet on glycemic control but also on complications is really important 5 .…”