Introduction: β-cell function declines progressively in patients with type 2 diabetes (T2D). the fasting C-peptide/glucose ratio (Cp/G) is used for its evaluation. The GLP1 receptor agonist liraglutide improves glucose and weight control, presumably due to improvement of β-cell function and/or mass. This study evaluates the effect of a 6-months treatment with liraglutide in β-cell function, measured by Cp/G, in patients with obesity and T2D.
Materials and methods: We analysed 43 patients (24 women) with orally treated T2D and obesity, to whom liraglutide 1.2 mg/day was added. At 3 months, liraglutide was increased to 1.8 mg/day if HbA1c or weight goals were not fully achieved. We evaluated clinical and analytical data before and after a 6-months treatment. Cp/G was used to assess β-cell function.
Results: Basal characteristics before liraglutide (mean±S.D.): BMI 39.3±4.9 kg/m2, T2D duration 6.7±3.8 years, fasting glucose (FG) 149.8±36.9 mg/dl, HbA1c 7.6±0.8%, HOMA 6.1±3.3, and Cp/G 0.0261±0.0103. 26 (60.5%) patients previously received one oral-hypoglycemic-agent (OHA), and the rest, two. At 3 months, dosage was increased to 1.8 mg/day in 24 (55.8%) cases; these patients had higher pre-treatment HbA1c (7.8±0.9% vs 7.3±0.7%, P=0.025) and lower Cp/G (0.0235±0.0099 vs 0.0295±0.0101, P=0.057), compared to those who remained on 1.2 mg/day. After 6 months of liraglutide, BMI 37.3±5.2 kg/m2, percentage weight loss (%WL) 5.2±4.8 kg, FG 132.5±47.3 mg/dl, HbA1c 6.8±1.2%, and HOMA 4.8±3.2 (P<0.05 in all cases). Cp/G at 6 months increased 15.4±36.6%, reaching 0.0296±0.0148 (P=0.047), regardless of pre-treatment HbA1c or final dosage of liraglutide. Pre-treatment Cp/G correlated with %WL (r=0.310, P=0.043) and HbA1c at 6 months (r=−0.482, P=0.001). Decrease of HbA1c and %WL were similar regardless of pre-treatment HbA1c, BMI, or Cp/G. Individuals with pre-treatment Cp/G within the lower quartile achieved 6-month HbA1c levels <7% less frequently.
Conclusions: Liraglutide seems to improve β-cell function, measured by Cp/G, after 6 months, regardless of basal BMI, HbA1c, or Cp/G. A lower basal Cp/G is associated to lower rates of optimal glucose control after 6 months of treatment with GLP1 agonists.
Disclosure: Grants from e-DM3 to Fundación SEEN.
16 - 20 May 2015
European Society of Endocrinology