Effect of Liraglutide Treatment on Whole Body Glucose Fluxes in C-peptide Positive Type 1 Diabetes During Hypoglycaemia
Publikation aus Health
Bioanalytik und Metabolomics, Institutsdirektor, Stab
Sabine Zenz, MD, Werner Regittnig, PhD, Beate Boulgaropoulos, PhD, Thomas Augustin, PhD, Martina Brunner, MSc, Stefan Korsatko, MD, Julia Münzker, PhD, Sophie H Narath, PhD, Reingard Raml, PhD Christoph Magnes, PhD Thomas R Pieber, MD
The Journal of Clinical Endocrinology & Metabolism , 7/2022
The effect of liraglutide in C-peptide positive (C-pos) type 1 diabetes (T1D) patients during hypoglycaemia remains unclear.
To investigate the effect of a 12-week liraglutide-treatment on the body glucose fluxes during a hypoglycaemic clamp in C-pos T1D patients and its impact on the alpha and beta cell responses during hypoglycaemia.
This was a randomized, double-blind, cross-over study. Each C-pos T1D patient was allocated to the treatment-sequence liraglutide/placebo or placebo/liraglutide with daily injections for 12 weeks adjunct to insulin-treatment, separated by a 4-week wash-out period.
Setting and Participants
14 T1D patients with fasting C-peptide ≥ 0.1 nmol/l.
All patients underwent a hyperinsulinaemic-stepwise-hypoglycaemic clamp with isotope tracer [plasma glucose (PG)-plateaus: 5.5, 3.5, 2.5 and 3.9 mmol/l] after a 3-month-liraglutide- (1.2 mg) or placebo-treatment.
Main Outcome Measure(s)
The responses of endogenous glucose production (EGP) and rate of peripheral glucose disposal (Rd) were similar for liraglutide- and placebo-treatment during the clamp.
The numbers of hypoglycaemic events were similar in both groups. At the clamp, mean glucagon levels were significantly lower at PG-plateau 5.5 mmol/l in the liraglutide- than in the placebo-group, but showed similar responses to hypoglycaemia in both groups. Mean C-peptide levels were significantly higher at PG-plateaus 5.5 and 3.5 mmol/l after liraglutide-treatment, but this effect was not reflected in EGP and Rd. HbA1c and body weight were lower and a trend for reduced insulin was seen after liraglutide-treatment.
The results indicate that three months liraglutide-treatment does not promote or prolong hypoglycaemia in C-pos T1D patients.
Keywords: type 1 diabetes, hypoglycaemia, liraglutide, beta cell function, GLP-1 analogue, clinical trial