SFEBES2014 Poster Presentations Obesity, diabetes, metabolism and cardiovascular (80 abstracts)
1University Hospitals Coventry and Warwickshire (UHCW), Coventry, UK; 2Warwick Medical School (WMS), University of Warwick, Coventry, UK; 3No Institution, Southampton, UK.
Introduction: Therapeutic durability of GLP1-based therapies in patients with type 2 diabetes mellitus (T2D) is incompletely understood. Our aim was to explore the therapeutic effects of GLP1 based therapies in patients with T2D.
Methods: This was a retrospective study on patients with T2D (n=55) who attend a specialist clinic at UHCW, Coventry, and who had been treated with the GLP1 based therapy, Liraglutide, for at least 6 months. A successful response to Liraglutide was defined as per NICE criteria, as a reduction in HbA1c by at least 1% and a reduction in body weight by at least 3%.
Results: Of the 55 patients included, 4 were excluded due to insufficient data. Of the remaining 51 patients, 23 (45%) responded successfully to Liraglutide therapy following 6 months of treatment. Of the 28 patients who failed to respond, the vast majority (n=23) had a satisfactory drop in either HbA1c or weight. Of those patients (n=23) who responded successfully to Liraglutide therapy, 13 (57%) remain on liraglutide therapy. Of these 13 patients, nine had an increase of HbA1c (mean increase 16.9% from 6-month value) following 20 months of therapy. Of the remaining four patients, one had a further increase in HbA1c (by 10% from the 6-month value) at 30 months of treatment.
Conclusions: Most patients with T2D appear to respond to initiation of Liraglutide therapy within the first 6 months of therapy, with just below half satisfying NICE criteria for successful therapy. After 6 months of therapy, there appears to be variable glycaemic response. Underlying progressive β-cell dysfunction is likely to be contributory, although there is a clear need to identify predictive baseline markers for successful response to initiation of GLP1-based therapies. Our data highlight the importance of close follow-up of patients on GLP1 based therapies.