Regimen comprising GLP-1 receptor agonist and basal insulin can decrease the effect of food on glycemic variability compared to a pre-mixed insulin regimen
Abstract Background Increasing evidence suggests that glucagon-like peptide 1 (GLP-1) receptor agonists (RA) can stabilize glycemic variability (GV) and interfere with eating behavior. This study compared the impact of insulin, GLP-1 RA, and dietary components on GV using professional continuous glu...
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BMC
2022-12-01
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| Series: | European Journal of Medical Research |
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| Online Access: | https://doi.org/10.1186/s40001-022-00892-9 |
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| author | Yi-Hsuan Lin Chia-Hung Lin Yu-Yao Huang Hsin-Yun Chen An-Shun Tai Shih-Chen Fu Sheng-Hwu Hsieh Jui-Hung Sun Szu-Tah Chen Sheng-Hsuan Lin |
| author_facet | Yi-Hsuan Lin Chia-Hung Lin Yu-Yao Huang Hsin-Yun Chen An-Shun Tai Shih-Chen Fu Sheng-Hwu Hsieh Jui-Hung Sun Szu-Tah Chen Sheng-Hsuan Lin |
| author_sort | Yi-Hsuan Lin |
| collection | DOAJ |
| description | Abstract Background Increasing evidence suggests that glucagon-like peptide 1 (GLP-1) receptor agonists (RA) can stabilize glycemic variability (GV) and interfere with eating behavior. This study compared the impact of insulin, GLP-1 RA, and dietary components on GV using professional continuous glucose monitoring (CGM). Methods Patients with type 2 diabetes underwent CGM before and after switching from a twice-daily pre-mixed insulin treatment regimen to a GLP-1 RA (liraglutide) plus basal insulin regimen. The dietary components were recorded and analyzed by a certified dietitian. The interactions between the medical regimen, GV indices, and nutrient components were analyzed. Results Sixteen patients with type 2 diabetes were enrolled in this study. No significant differences in the diet components and total calorie intake between the two regimens were found. Under the pre-mixed insulin regimen, for increase in carbohydrate intake ratio, mean amplitude of glucose excursion (MAGE) and standard deviation (SD) increased; in contrast, under the new regimen, for increase in fat intake ratio, MAGE and SD decreased, while when the protein intake ratio increased, the coefficient of variation (CV) decreased. The impact of the food intake ratio on GV indices disappeared under the GLP-1 RA regimen. After switching to the GLP-1 RA regimen, the median MAGE, SD, and CV values decreased significantly. However, the significant difference in GV between the two regimens decreased during the daytime. Conclusion A GLP-1 RA plus basal insulin regimen can stabilize GV better than a regimen of twice-daily pre-mixed insulin, especially in the daytime, and can diminish the effect of food components on GV. |
| format | Article |
| id | doaj-art-0476cdf8feb94e33872574c4e9c505b8 |
| institution | DOAJ |
| issn | 2047-783X |
| language | English |
| publishDate | 2022-12-01 |
| publisher | BMC |
| record_format | Article |
| series | European Journal of Medical Research |
| spelling | doaj-art-0476cdf8feb94e33872574c4e9c505b82025-08-20T02:51:42ZengBMCEuropean Journal of Medical Research2047-783X2022-12-0127111010.1186/s40001-022-00892-9Regimen comprising GLP-1 receptor agonist and basal insulin can decrease the effect of food on glycemic variability compared to a pre-mixed insulin regimenYi-Hsuan Lin0Chia-Hung Lin1Yu-Yao Huang2Hsin-Yun Chen3An-Shun Tai4Shih-Chen Fu5Sheng-Hwu Hsieh6Jui-Hung Sun7Szu-Tah Chen8Sheng-Hsuan Lin9Department of Biological Science and Techonology, National Yang Ming Chiao Tung UniversityDivision of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou branchDivision of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou branchDivision of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou branchInstitute of Statistics, National Chiao Tung UniversityInstitute of Statistics, National Chiao Tung UniversityDivision of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou branchDivision of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou branchDivision of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou branchInstitute of Statistics, National Chiao Tung UniversityAbstract Background Increasing evidence suggests that glucagon-like peptide 1 (GLP-1) receptor agonists (RA) can stabilize glycemic variability (GV) and interfere with eating behavior. This study compared the impact of insulin, GLP-1 RA, and dietary components on GV using professional continuous glucose monitoring (CGM). Methods Patients with type 2 diabetes underwent CGM before and after switching from a twice-daily pre-mixed insulin treatment regimen to a GLP-1 RA (liraglutide) plus basal insulin regimen. The dietary components were recorded and analyzed by a certified dietitian. The interactions between the medical regimen, GV indices, and nutrient components were analyzed. Results Sixteen patients with type 2 diabetes were enrolled in this study. No significant differences in the diet components and total calorie intake between the two regimens were found. Under the pre-mixed insulin regimen, for increase in carbohydrate intake ratio, mean amplitude of glucose excursion (MAGE) and standard deviation (SD) increased; in contrast, under the new regimen, for increase in fat intake ratio, MAGE and SD decreased, while when the protein intake ratio increased, the coefficient of variation (CV) decreased. The impact of the food intake ratio on GV indices disappeared under the GLP-1 RA regimen. After switching to the GLP-1 RA regimen, the median MAGE, SD, and CV values decreased significantly. However, the significant difference in GV between the two regimens decreased during the daytime. Conclusion A GLP-1 RA plus basal insulin regimen can stabilize GV better than a regimen of twice-daily pre-mixed insulin, especially in the daytime, and can diminish the effect of food components on GV.https://doi.org/10.1186/s40001-022-00892-9Continuous glucose monitoringGlucose variabilityPre-mixed insulinGLP-1 receptor agonistDiet |
| spellingShingle | Yi-Hsuan Lin Chia-Hung Lin Yu-Yao Huang Hsin-Yun Chen An-Shun Tai Shih-Chen Fu Sheng-Hwu Hsieh Jui-Hung Sun Szu-Tah Chen Sheng-Hsuan Lin Regimen comprising GLP-1 receptor agonist and basal insulin can decrease the effect of food on glycemic variability compared to a pre-mixed insulin regimen European Journal of Medical Research Continuous glucose monitoring Glucose variability Pre-mixed insulin GLP-1 receptor agonist Diet |
| title | Regimen comprising GLP-1 receptor agonist and basal insulin can decrease the effect of food on glycemic variability compared to a pre-mixed insulin regimen |
| title_full | Regimen comprising GLP-1 receptor agonist and basal insulin can decrease the effect of food on glycemic variability compared to a pre-mixed insulin regimen |
| title_fullStr | Regimen comprising GLP-1 receptor agonist and basal insulin can decrease the effect of food on glycemic variability compared to a pre-mixed insulin regimen |
| title_full_unstemmed | Regimen comprising GLP-1 receptor agonist and basal insulin can decrease the effect of food on glycemic variability compared to a pre-mixed insulin regimen |
| title_short | Regimen comprising GLP-1 receptor agonist and basal insulin can decrease the effect of food on glycemic variability compared to a pre-mixed insulin regimen |
| title_sort | regimen comprising glp 1 receptor agonist and basal insulin can decrease the effect of food on glycemic variability compared to a pre mixed insulin regimen |
| topic | Continuous glucose monitoring Glucose variability Pre-mixed insulin GLP-1 receptor agonist Diet |
| url | https://doi.org/10.1186/s40001-022-00892-9 |
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