Introduction
Background: Overweight and obesity are closely associated with insulin resistance and type 2 diabetes mellitus (T2DM). Weight loss has been shown to improve glucose metabolism in people with type 2 diabetes. However, diet and exercise are rarely enough to lose weight. Many antidiabetic drugs, including insulin, can cause weight gain as a side effect. Therefore, weight control has become a focus in the treatment of overweight or obese patients with type 2 diabetes. In recent years, an increasing number of antidiabetic drugs have focused on weight control and lowering blood sugar levels. Representative drugs, such as glucagon-like peptide-1 (GLP-1) analogs or GLP-1 receptor agonists, work by
Keywords: diabetes
Background: Overweight and obesity are closely associated with insulin resistance and type 2 diabetes mellitus (T2DM). Weight loss has been shown to improve glucose metabolism in people with type 2 diabetes. However, diet and exercise are rarely enough to lose weight. Many antidiabetic drugs, including insulin, can cause weight gain as a side effect. Therefore, weight control has become a focus in the treatment of overweight or obese patients with type 2 diabetes.
In recent years, an increasing number of antidiabetic drugs have focused on weight control and lowering blood sugar levels. Representative drugs, such as glucagon-like peptide-1 (GLP-1) analogs or GLP-1 receptor agonists, reduce weight by acting on the nervous system to cause a decrease in appetite and the gastrointestinal tract by delaying gastric excretion. Empty to reduce food intake, and white fat browns to reduce weight. Liraglutide is a widely used long-acting GLP-1 analog that has been shown to aid weight loss in the Liraglutide Effects and Actions in Diabetes (LEAD) study and in clinical practice. Nonetheless, its weight loss effects are highly variable among different patients and in some cases in clinical settings it is ineffective. Therefore, it is necessary to study the clinical characteristics of effective weight loss in patients treated with liraglutide.
The main clinical factors that affect the potential weight loss of liraglutide treatment include baseline obesity status (body mass index, BMI), baseline abdominal obesity (waist circumference, WC), gastrointestinal adverse reactions (GAR), liraglutide dosage, Patient age. It is critical to explore factors that are highly influential in liraglutide-mediated weight loss.
Purpose: In this study, we identified the determinants of obese or overweight type 2 diabetes patients in Northeast China who are poorly controlled with oral medications to provide better evidence for predicting the weight loss effect of liraglutide treatment.
Design: Prospective study.
Methods: Patients with type 2 diabetes taking oral medications and with a body mass index (BMI) greater than or equal to 24 kg/m2 were prospectively studied. Treat with liraglutide for at least 12 weeks, maintain the original hypoglycemic regimen (Phase I), and then continue or stop liraglutide treatment from 13 to 52 weeks (Phase II) as the patient deems appropriate, and analyze the impact Factors underlying the weight loss effects of liraglutide.
Results: Of the 127 subjects, 90 had comprehensive follow-up data at week 12. During Phase I, subjects' blood glucose levels and body weight decreased significantly (P < 0.001). Among all significant factors, gastrointestinal adverse reaction score (GARS) was more strongly associated with changes in BMI (ΔBMI; r = 0.43) and changes in waist circumference (ΔWC; r = 0.32) than baseline BMI (BMI0) and WC ( WC0). At week 12, linear regression showed that BMI0 independently affected ΔBMI and ΔWC, while WC0 only affected ΔWC. GARS was significantly associated with ΔBMI and ΔWC, and this association persisted through week 52, even after most subjects had discontinued liraglutide treatment.
Conclusion: Obesity level and gastrointestinal adverse effects are the most promising predictors of weight loss with liraglutide treatment.
Original source: ZhouF, JiangL, GuoJ, et al. Degree of obesity and gastrointestinal adverse reactions influence the weight loss effect of liraglutide in overweight or obese patients with type 2 diabetes.Ther Adv Chronic Dis2023;14
