Introduction: Type 2 Diabetes Mellitus (DM2) is an important health problem at present, with high morbidity, mortality, direct and indirect costs. New management strategies have been implemented to reduce their impact. This study describes the experience of handling GLP-1 analogs.
Methods: Retrospective, descriptive study of patients with DM2 on management with GLP-1 analogues. Clinical characteristics were described at the beginning of therapy and control between 3 and 6 months.
Results: Of 69 patients, 55.1% were women, the average age was 57.1 years. The median duration of DM2 was 13 years. A significant reduction of weight kg (p=0.00), the HbA1c 1.7% (p = 0), the fasting glycemia 41 mg/dL (p = 0), the total cholesterol 14 mg/dL (P = 0.0069), the triglycerides 38 mg/dL (0.0247) was found. There were no significant changes in blood pressure, HDL and LDL cholesterol.
Conclusion: GLP-1 analogs in patients with T2DM generate significant improvement in glycemic control, weight and cholesterol. Long-term follow-up is necessary to determine maintenance of glycemic control, weight loss and impact on cardiovascular risk.
2. UK Prospective Diabetes Study (UKPDS) Group. (1998). lntensive blood- glucose control with sulphonylureas or insulin compared with conventional treatment and risk of camplications in patients with type 2 diabetes (UKPDS 33). The Lancet, 1998; 352: 837-853.
3. ADVANCE Collaborative Group (2008). Intensive Blood Glucose Control and Vascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med. 2008; (358), 2560- 2572.
4. William Duckworth, Carlos Abraira, Thomas Moritz, Domenic Reda, Nicholas Emanuele, Peter D. Reaven, et al. Glucose Control and Vascular Complications in Veterans with Type 2 Diabetes. N Engl J Med. 2009; 360:129-39.
5. Buse, J, Drucker, D, Taylor K, Kim T, Walsh B, Hu H, et al. DURATION-1: ex- enatide once weekly produces sustained glycemic control and weight loss over 52 weeks. Diabetes Care. 2010; 33: 1255–1261.
6. Buse J, Nauck M, Forst T, SheZ W, Shenouda S, Heilmann C. et al. Exenatide once weekly versus liraglutide once daily in patients with type 2 diabetes (DURATION-6). A randomized open-label study. Lancet, 2013; 381: 117– 124.
7. Steven P. Marso, Gilbert H. Daniels, Kirstine Brown-Frandsen, Peter Kristensen, Johannes F.E. Mann, Michael A. Nauck, y cols. For the LEADER Steering committee on behalf of the LEADER Trial Investigators. Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med. 2016; 375:311- 22.
8. Pfeffer MA, Claggett B, Diaz R, Dickstein K, Gerstein HC, Køber LV, et al. for the ELIXA Investigators. Lixisenatide in Patients with Type 2 Diabetes and Acute Coronary Syndrome. N Engl J Med, 2015; 373:2247-57.
9. Buse J, Rosenstock J, Sesti G, Schmidt W, Montanya E, Brett J. et al. Liraglutide once a day versus exenatide twice a day for type 2 diabetes: a 26-week randomised, parallel-group, multinational, open-label trial (LEAD-6). Lancet, 2009; 374: 39–47.
10. American Diabetes Association. (2016). Standards of medical care in diabetes- 2016. Diabetes care, 39 (Suppl 1), S13-S22.
11. Zimmet P, Alberti KG, Shaw J. Global and societal implications of the diabetes epidemic. Nature. 2001; 414:782-787
12. Kumar PR, Bhansali A, Ravikiran M, et al. Utility of glycated hemoglobin in diagnosing type 2 diabetes mellitus: A community-based study. J Clin Endocrinol Metab 2010; 95:2832–2835
13. Análisis de Situación de Salud, COLOMBIA 2014. MINSALUD, Bogotá, D. C., Colombia, 2014, pp: 146-148.
14. Sten Madsbad. Review of head-to-head comparisons of glucagon-like peptide-1 receptor agonists. Diabetes, Obesity and Metabolism 18: 317–332, 2016.
15. Stephen C L Gough, Bruce Bode, Vincent Woo, Helena W Rodbard, Sultan Linjawi, Pernille Poulsen et al. Efficacy and safety of a fixed-ratio combination of insulin degludec and liraglutide (IDegLira) compared with its components given alone: results of a phase 3, open-label, randomised, 26-week, treat-to-target trial in insulin-naive patients with type 2 diabetes. Lancet Diabetes Endocrinol 2014 Nov;2(11):885-93
16. C. Mathieu, H. W. Rodbard, B. Cariou, Y. Handelsman, A. Philis-Tsimikas, A. M. Ocampo Francisco, et al. A comparison of adding liraglutide versus a single daily dose of insulin aspart to insulin degludec in subjects with type 2 diabetes (BEGIN: VICTOZA ADD-ON. Diabetes, Obesity and Metabolism 16: 636–644, 2014.
17. Marcus Lind, Irl B Hirsch, Jaakko Tuomilehto, Sofia Dahlqvist, Bo Ahrén, Ole Torffvit, et al. Liraglutide in people treated for type 2 diabetes with multiple daily insulin injections: randomised clinical trial (MDI Liraglutide trial). BMJ 2015;351: h5364.
18. García de Lucas M, Olalla J, Sempere M. Liraglutida reduce biomarcadores y riesgo vascular en pacientes con diabetes mellitus tipo 2. Rev Med Chil;141(12): 1602-1604, dic. 2013.
19. Davidson JA, Orsted DD, Campos C. Efficacy and safety of liraglutide, a once- daily human glucagon-like peptide-1 analogue, in Latino/Hispanic patients with type 2 diabetes: post hoc analysis of data from four phase III trials. Diabetes, Obesity and Metabolism 18: 725–728, 2016.
20. Buse, J, Drucker, D, Taylor K, Kim T, Walsh B, Hu H, et al. DURATION-1: ex- enatide once weekly produces sustained glycemic control and weight loss over 52 weeks. Diabetes Care. 2010; 33: 1255–1261.
21. Du Q1, Wang YJ, Yang S, Zhao YY, Han P. Liraglutide for the Treatment of Type 2 Diabetes Mellitus: A Meta-analysis of Randomized Placebo-Controlled Trials. Adv Ther.2014. 31:1182–1195
22. Zachary t. Bloomgarden, Regina Dodis, Catherine m. Viscoli, Eric s. Holmboe, Silvio e. Inzucchi. Lower Baseline Glycemia Reduces Apparent Oral Agent Glucose-Lowering Efficacy. Diabetes care, volume 29, number 9, september 2006
23. Yu Mi Kang, Chang Hee Jung. Cardiovascular Effects of Glucagon-Like Peptide-1 Receptor Agonists. Endocrinol Metab 2016; 31:258-274
24. Russo G, Pintaudi B, Giorda C, Lucisano G, Nicolucci A, Cristofaro MR, et al. Age- and Gender-Related Differences in LDL-Cholesterol Management in Outpatients with Type 2 Diabetes Mellitus. Int J Endocrinol
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