Liraglutide for treating type 1 diabetes

ABSTRACT

Introduction: Many persons with type 1 diabetes do not achieve glycemic targets, why new treatments, complementary to insulin, are of interest. Liraglutide, a long-acting glucagon-like peptide-1 receptor agonist could be a potential pharmacological supplement to insulin. This review discusses the mechanism of actions, efficacy and safety of liraglutide as add-on to insulin in persons with type 1 diabetes.

Areas covered: Physiological and clinical data on liraglutide in type 1 diabetes were reviewed. We searched the Cochrane library, MEDLINE and EMBASE, with the final search performed February 16, 2016.

Expert opinion: Liraglutide as adjunct to insulin treatment reduced body weight and daily dose of insulin compared with insulin alone. The effect on HbA1c was inconsistent with mostly uncontrolled, small-scale studies reporting improvements in glycemic control. In placebo-controlled studies there was no clinically relevant effect on HbA1c. Adverse events were mostly transient gastrointestinal side effects, primarily nausea. Based on the available data, liraglutide cannot be recommended as add-on therapy to insulin in persons with type 1 diabetes with the aim to improve glycemic control. Ongoing trials in newly diagnosed patients with type 1 diabetes and in insulin pump-treated patients will help define the future role of liraglutide therapy in type 1 diabetes.

KEYWORDS:

• Type 1 diabetes
• liraglutide
• glucagon-like peptide-1
• GLP-1 receptor agonist
• HbA1c
• body weight
• hypoglycaemia

Declaration of interest

TFD has received research support and lecture fees from Novo Nordisk. CSF has received research support and lecture fees from Novo Nordisk. JJH has served on advisory boards for Novartis Pharma, Novo Nordisk, Merck Sharp & Dome, Sanofi-Aventis, AstraZeneca, Roche, Mankind, Boehringer-Ingelheim, Zealand, and Intarcia Therapeutics and has received lecture fees from Novo Nordisk, Merck Sharp & Dome, AstraZeneca, Roche, Sanofi-Aventis, Eli Lilly and Bristol-Myers Squibb. JJH is a consultant for Novo Nordisk. SM has served on advisory boards for Novartis Pharma, Novo Nordisk, Merck Sharp & Dome, Sanofi-Aventis, AstraZeneca, Johnson & Johnson, Roche, Mankind, Boehringer-Ingelheim, Zeeland, Eli Lilly and Intarcia Therapeutics, and has received lecture fees from Novo Nordisk, Merck Sharp & Dome, Astra-Zeneca, Johnson and Johnson, Roche, Shering-Plough, Sanofi-Aventis, Novartis Pharma, Eli Lilly and Bristol-Myers Squibb. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Supplemental data

Supplemental data for this article can be accessed here.