Published June 29, 2011
A small observational study conducted by University at Buffalo researchers suggests that liraglutide, an injectable medication used to treat type 2 diabetes, also helps control blood glucose levels in type 1 diabetes.
If the findings are confirmed by a larger study now being planned, they could represent the first significant new treatment for type 1 diabetes since people started taking insulin in the 1920s.
In addition to having lower blood sugar, the patients on liraglutide had smaller appetites and ate less. The body weight of those who took the drug for 24 weeks fell markedly.
“This study shows that liraglutide can provide even well-controlled type 1 diabetics with additional benefits that help them achieve even better blood glucose levels,” says Paresh Dandona, MD, PhD, UB Distinguished Professor of Medicine and senior author on the study.
The study is published in the European Journal of Endocrinology in an article titled Liraglutide as Additional Treatment in Type 1 Diabetes.
It was presented at the annual meeting of the Endocrine Society in Boston, where participants recognized it as one of the most outstanding abstracts presented and the best in the field of diabetes.
The study was a retrospective analysis of data. It involved 14 adult patients on insulin for type 1 diabetes who took liraglutide (marketed as Victoza) for periods ranging from one week to 24 weeks. At the outset, all of their hemoglobin A1C levels were under 7, which is considered optimal.
In the paper, the patients were characterized as “well-controlled . . . meticulous and disciplined” in terms of their ability to control their blood glucose levels with insulin. Nevertheless, Dandona notes, even well-controlled type 1 diabetic patients still experience "glycemic excursions"—fairly wide swings in blood glucose numbers, ranging from the hyperglycemic to the hypoglycemic.
“The addition of liraglutide to insulin therapy in these well-controlled type 1 diabetics resulted in a significant and rapid reduction in glycemic excursions and, as a consequence, a rapid reduction in the amount of insulin they needed to take.”
The improvements occurred within one to two days of beginning treatment with liraglutide.
They reversed just as rapidly when treatment was discontinued, signifying that the drug was responsible for these beneficial effects.
The mechanism behind these improvements is not well understood.
Dandona and his co-authors suggest that liraglutide may suppress the post-meal increase in glucagon, the hormone that raises glucose levels, in type 1 diabetics.
The UB researchers are now planning a much larger, randomized multicenter study of liraglutide in type 1 diabetics.
“We will be investigating in detail the hypothesis that it is liraglutide’s ability to suppress glucagon that significantly reduces the wide swings in blood glucose levels that type 1 diabetics—even those with very good glucose control—live with every day,” says Dandona.
Along with Dandona, co-authors of the original study included Ajay Varanesi, MD, endocrinology fellow; Natalie Bellini, RN, CDE, honorary research fellow; Deepti Rawal, MD, UB medical resident; Mehul Vora, MD, clinical assistant instructor; Sandeep Dhindsa, MD, assistant professor of medicine; Antoine Makdissi, MD, assistant professor of medicine; and Ajay Chaudhuri, MD, associate professor of medicine.