Endocrine Abstracts

Introduction: Glucagon-like peptide-1(GLP-1) agonists are widely used for treatment of type 2 diabetes(T2D). To date a number of reports have described improvements in glucose control with the addition of a GLP-1 agonist to the insulin regime in treatment of type 1 diabetes(T1D). From a physiological perspective there is credence to the notion that a GLP-1 agonist will lower glucose levels in people with T1D as they do in T2D. GLP-1 is an endogenous hormone that regulates secretion of both insulin and glucagon in response to meals. GLP-1 agonists also slow gastric emptying through effects on the autonomic nervous system/act centrally to increase satiety. Liraglutide is the most widely studied GLP-1 agonist in adults with T1D, as add-on therapy to insulin.ReportOur patient has experienced challenges with their T1D management for a number of years in spite of being maintained on a basal bolus regime and recently developed a foot ulcer (now healed). He works long hours in his own business. With the addition of Liraglutide to the basal bolus regime, by 8 weeks there was a frameshift in glucose profile as evidenced by FreeStyle® glucose monitoring. Time in range glucose (3.9-10.0mmol/l) increased from 43% to 80% with the percentage in the range >10.0mmol/l decreasing from 35% to 15%. Also variability decreased from 42.3% to 32.4%% and estimated HbA1c from 72mmol/mol to 52mmol/mol. The change in glucose levels was associated with a self-reported enhancement of sense of control of the T1DM day to day. In his own words ‘I feel in control of my diabetes for the first time in 20 years’.

Conclusion: We here report a ‘good news story’ of the benefits of GLP-1 agonist treatment in T1D in relation both to quantitative glucose profile and an individual’s sense of agency in their self-management.