Adding liraglutide 3 mg to insulin improves weight loss in T2D

  • Garvey WT & al.
  • Diabetes Care
  • 5 Mar 2020

  • curated by Miriam Tucker
  • Clinical Essentials
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Takeaway

  • In basal insulin-treated individuals with overweight/obesity and type 2 diabetes (T2D), liraglutide 3.0 mg (weight-loss dose) produced greater weight loss and improved glycemic control compared with placebo, with less hypoglycemia.

Why this matters

  • Weight gain is common following insulin initiation.

Study design

  • Satiety and Clinical Adiposity-Liraglutide Evidence Insulin was a randomized, double-blind, placebo-controlled, multinational trial in 396 individuals with overweight/obesity and T2D, treated with basal insulin, intensive behavioral therapy, and ≤2 oral glucose-lowering drugs, randomly allocated to liraglutide or placebo.
  • Funding: Novo Nordisk A/S.

Key results

  • At 56 weeks, mean weight loss was 5.8% with liraglutide 3.0 mg vs 1.5% with placebo (P<.0001>
  • Proportions losing ≥5% of body weight:
    • 51.8% liraglutide vs 24.0% placebo.
    • OR, 3.41 (P<.0001>
  • Proportions losing >10% of body weight,
    • 22.8% liraglutide vs 6.6% placebo.
    • OR, 4.21 (P<.0001>
  • Significantly greater HbA1c reduction seen with liraglutide 3.0 mg vs placebo:
    • 1.1% vs 0.6% (P<.0001>
  • More gastrointestinal adverse events seen with liraglutide (62.1% vs 46.7% placebo), specifically mild-moderate nausea (29.7% vs 11.7%).
  • Hypoglycemia rates were lower with liraglutide vs placebo (742.3 vs 937.9 events/100 patient-years), but severe hypoglycemia episodes were similar (3 vs 2).

Limitations

  • Trial participants were informed about possible gastrointestinal events, which were self-reported.