- In patients with early type 2 diabetes (T2D) or impaired glucose tolerance (IGT), active treatment that improves beta-cell function does not have lasting effects following drug withdrawal.
- Findings of RISE (Restoring Insulin Secretion) trial vary from those of DiRECT, showing 2-year benefit of rapid weight loss to levels that are sustained for 2 years.
Why this matters
- Authors expressed surprise at the findings, saying the results suggest the importance of continuing therapy.
- All active treatments (12 months) in the trial yielded HbA1c improvements, weight loss vs placebo.
- Liraglutide+metformin produced greatest improvement.
- Adherence to the regimens was >90% for all groups.
- At 3 months following treatment withdrawal, beta-cell improvements had not persisted in any group.
- 3-center, randomized, partially blinded trial involving 267 adults with IGT (197) or T2D (70).
- 4 treatment groups: metformin only for 12 months; 3 months insulin glargine followed by 9 months of metformin; 12 months of liraglutide+metformin; 12 months of placebo.
- Outcome: beta-cell function at 15 months vs baseline.
- Funding: National Institute of Diabetes and Digestive and Kidney Diseases; ADA; Novo Nordisk A/S and other industry; others.
- Target fasting glycemia had low achievement rate with glargine.
- Fewer completers among liraglutide-metformin group.