Weight loss maintenance with exercise and liraglutide improves glucose tolerance, glucagon response, and beta cell function

Abstract

Objective: The aim of this study was to investigate glucose tolerance, glucagon response, and beta cell function during a 1-year maintenance period with either exercise, the glucagon-like peptide-1 receptor agonist liraglutide, or the combination after diet-induced weight loss.Methods: In this randomized placebo-controlled trial, adults with obesity (BMI: 32-43 kg/m 2 ) without diabetes underwent an 8-week low-calorie diet (800 kcal/d) and were randomized to 52 weeks of aerobic exercise, liraglutide 3.0 mg/d, exercise and liraglutide combined, or placebo. Change in glucose and glucagon response to a 3-hour mixed meal test and disposition index, as a measure of beta cell function, were measured.Results: A total of 195 participants were randomized. After 1 year of treatment, the combination group had decreased postprandial glucose response by À9% (95% CI: À14% to À3%; p = 0.002), improved beta cell function by 49% (95% CI: 16% to 93%; p = 0.002), and decreased glucagon response by À18% (95% CI: À34% to À3%; p = 0.024) compared with placebo. Compared with placebo, liraglutide alone improved postprandial glucose response by À7% (95% CI: À12% to À1%; p = 0.018), but not beta cell function or glucagon. Exercise alone had similar postprandial glucose response, beta cell function, and glucagon response as placebo.Conclusions: Only the combination of exercise and liraglutide improved glucose tolerance, beta cell function, and glucagon responses after weight loss.

Healthy weight loss maintenance with exercise, GLP-1 receptor agonist, or both combined followed by one year without treatment: a post-treatment analysis of a randomised placebo-controlled trial

“…Overall, the study consisted of three phases: an eight-week weight loss phase (week −8 to 0), a 52-week randomised, controlled weight maintenance phase (week 0–52), and a one-year post-treatment phase (week 52–104). The results of the first two phases, i.e., the weight loss (week −8 to 0) and weight maintenance (week 0–52) phases, have been published previously, 7 , 26 , 27 and the results of this paper are based on the post-treatment phase alone (week 52–104) and in combination with the weight maintenance phase (week 0–104).

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