Glucagon-like peptide-1 receptor agonists in patients with type 2 diabetes:real-world evidence from a Mediterranean area

Curr Med Res Opin. 2019 Oct;35(10):1735-1744. doi: 10.1080/03007995.2019.1618806. Epub 2019 Jun 17.

Abstract

Aims: To assess clinical characteristics and factors associated with glycated hemoglobin (HbA1c) reduction in type 2 diabetes (T2DM) patients initiating glucagon-like peptide-1 receptor agonists (GLP-1RAs). Methods: Retrospective cohort study in patients with T2DM who initiated GLP-1RAs between 2007 and 2014 in primary health care centers in Catalonia (Spain). We evaluated changes in HbA1c and body weight at 6-12 months, and factors independently associated with achieving ≥1% HbA1c target reduction. Results: Overall, 4242 patients (47.9% male; mean BMI 37.5 kg/m2) initiated a GLP-1RA. At 6-12 months, the mean HbA1c level decreased from the baseline 8.8% to 7.7% (-1.0%; SD = 1.6). A 1% reduction in HbA1c was observed in 47.2% of patients. Patients lost a mean of 3.6 kg (SD = 6.2). Sixty percent of patients reduced both HbA1c and body weight, and 17% achieved only one of these targets. Independent determinants of a 1% HbA1c reduction were baseline HbA1c, age, diabetes duration and being on insulin treatment. Reduction in weight or HbA1c and the proportion of patients achieving a HbA1c reduction of ≥1% was significantly larger among subjects prescribed liraglutide than exenatide and lixisenatide. Conclusions: In this real-world, retrospective study, the magnitude of HbA1c and body weight reductions after addition of a GLP-1RA were similar to those observed in randomized controlled trials. Approximately 60% of patients attained reductions in both HbA1c and body weight, and there were significant differences among different drugs from this therapeutic group.

Keywords: GLP-1 analogue; glycemic control; observational study; primary care; type 2 diabetes mellitus.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Body Weight / drug effects
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Female
  • Glucagon-Like Peptide-1 Receptor Agonists*
  • Glycated Hemoglobin / analysis
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Male
  • Middle Aged
  • Retrospective Studies

Substances

  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • hemoglobin A1c protein, human
  • Glucagon-Like Peptide-1 Receptor Agonists