Predictors of Responsiveness to GLP-1 Receptor Agonists in Insulin-Treated Patients with Type 2 Diabetes
Background. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are potent antihyperglycemic agents with beneficial effects on weight, cardiovascular, and renal outcomes. Physicians lack guidance as to which patients with insulin-requiring type 2 diabetes will respond best to GLP-1 RAs with respec...
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| Format: | Article |
| Language: | English |
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Wiley
2023-01-01
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| Series: | Journal of Diabetes Research |
| Online Access: | http://dx.doi.org/10.1155/2023/9972132 |
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| author | Colleen Gavigan Thomas Donner |
| author_facet | Colleen Gavigan Thomas Donner |
| author_sort | Colleen Gavigan |
| collection | DOAJ |
| description | Background. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are potent antihyperglycemic agents with beneficial effects on weight, cardiovascular, and renal outcomes. Physicians lack guidance as to which patients with insulin-requiring type 2 diabetes will respond best to GLP-1 RAs with respect to glycemic control, insulin dose reduction, and weight loss. This study evaluated the efficacy of GLP-1 RAs in patients with type 2 diabetes on insulin and patient factors that may predict a beneficial clinical response. Methods. Adults with type 2 diabetes treated with insulin who had a GLP-1 RA added to their regimen were evaluated retrospectively. Baseline parameters and outcomes at 3, 6, and 12 months were collected. Results. Among the 81 patients included, there was a mean reduction in hemoglobin A1C of 0.94% (SD, 0.26; p=0.0007), 0.40% (SD, 0.21; p=0.0636), and 0.58% (SD, 0.23, p=0.0154) at 3, 6, and 12 months, respectively, following the addition of a GLP-1 RA. There was also a reduction in body weight noted at each time point. Baseline characteristics including BMI, duration of diabetes, and insulin requirement did not significantly affect A1C reduction when GLP-1 RA was added. At 3 months, patients with a random C-peptide that was normal (≥0.8 ng/ml) were significantly more likely to have discontinued insulin than those with random C-peptide that was low (<0.8 ng/ml) (11 of 23 vs. 0 of 7 patients, p=0.029). Conclusions. The addition of a GLP-1 RA reduced HbA1C, weight, and insulin requirements in this cohort of patients with type 2 diabetes on insulin. BMI, baseline insulin dose, and diabetes duration did not predict response. A C-peptide level≥0.8 ng/ml predicted a beneficial response after 3 months of therapy. |
| format | Article |
| id | doaj-art-8ca4001cb430475e91c0f6fd3595af0a |
| institution | Kabale University |
| issn | 2314-6753 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Diabetes Research |
| spelling | doaj-art-8ca4001cb430475e91c0f6fd3595af0a2025-08-20T03:37:44ZengWileyJournal of Diabetes Research2314-67532023-01-01202310.1155/2023/9972132Predictors of Responsiveness to GLP-1 Receptor Agonists in Insulin-Treated Patients with Type 2 DiabetesColleen Gavigan0Thomas Donner1Johns Hopkins Diabetes CenterJohns Hopkins Diabetes CenterBackground. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are potent antihyperglycemic agents with beneficial effects on weight, cardiovascular, and renal outcomes. Physicians lack guidance as to which patients with insulin-requiring type 2 diabetes will respond best to GLP-1 RAs with respect to glycemic control, insulin dose reduction, and weight loss. This study evaluated the efficacy of GLP-1 RAs in patients with type 2 diabetes on insulin and patient factors that may predict a beneficial clinical response. Methods. Adults with type 2 diabetes treated with insulin who had a GLP-1 RA added to their regimen were evaluated retrospectively. Baseline parameters and outcomes at 3, 6, and 12 months were collected. Results. Among the 81 patients included, there was a mean reduction in hemoglobin A1C of 0.94% (SD, 0.26; p=0.0007), 0.40% (SD, 0.21; p=0.0636), and 0.58% (SD, 0.23, p=0.0154) at 3, 6, and 12 months, respectively, following the addition of a GLP-1 RA. There was also a reduction in body weight noted at each time point. Baseline characteristics including BMI, duration of diabetes, and insulin requirement did not significantly affect A1C reduction when GLP-1 RA was added. At 3 months, patients with a random C-peptide that was normal (≥0.8 ng/ml) were significantly more likely to have discontinued insulin than those with random C-peptide that was low (<0.8 ng/ml) (11 of 23 vs. 0 of 7 patients, p=0.029). Conclusions. The addition of a GLP-1 RA reduced HbA1C, weight, and insulin requirements in this cohort of patients with type 2 diabetes on insulin. BMI, baseline insulin dose, and diabetes duration did not predict response. A C-peptide level≥0.8 ng/ml predicted a beneficial response after 3 months of therapy.http://dx.doi.org/10.1155/2023/9972132 |
| spellingShingle | Colleen Gavigan Thomas Donner Predictors of Responsiveness to GLP-1 Receptor Agonists in Insulin-Treated Patients with Type 2 Diabetes Journal of Diabetes Research |
| title | Predictors of Responsiveness to GLP-1 Receptor Agonists in Insulin-Treated Patients with Type 2 Diabetes |
| title_full | Predictors of Responsiveness to GLP-1 Receptor Agonists in Insulin-Treated Patients with Type 2 Diabetes |
| title_fullStr | Predictors of Responsiveness to GLP-1 Receptor Agonists in Insulin-Treated Patients with Type 2 Diabetes |
| title_full_unstemmed | Predictors of Responsiveness to GLP-1 Receptor Agonists in Insulin-Treated Patients with Type 2 Diabetes |
| title_short | Predictors of Responsiveness to GLP-1 Receptor Agonists in Insulin-Treated Patients with Type 2 Diabetes |
| title_sort | predictors of responsiveness to glp 1 receptor agonists in insulin treated patients with type 2 diabetes |
| url | http://dx.doi.org/10.1155/2023/9972132 |
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