Predictors of Effectiveness of Glucagon-Like Peptide-1 Receptor Agonist Therapy in Patients with Type 2 Diabetes and Obesity

Rationale. It is well known that diabetes mellitus (DM) exacerbates the mechanisms underlying atherosclerosis. Currently, glucagon-like peptide-1 receptor agonists (aGLP-1) have one of the most prominent cardioprotective effects among the antidiabetic agents. However, the treatment with aGLP-1 is ef...

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Main Authors: Alina Yu. Babenko, Daria A. Savitskaya, Yulia A. Kononova, Aleksandra Yu. Trofimova, Anna V. Simanenkova, Elena Yu. Vasilyeva, Evgeny V. Shlyakhto
Format: Article
Language:English
Published: Wiley 2019-01-01
Series:Journal of Diabetes Research
Online Access:http://dx.doi.org/10.1155/2019/1365162
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author Alina Yu. Babenko
Daria A. Savitskaya
Yulia A. Kononova
Aleksandra Yu. Trofimova
Anna V. Simanenkova
Elena Yu. Vasilyeva
Evgeny V. Shlyakhto
author_facet Alina Yu. Babenko
Daria A. Savitskaya
Yulia A. Kononova
Aleksandra Yu. Trofimova
Anna V. Simanenkova
Elena Yu. Vasilyeva
Evgeny V. Shlyakhto
author_sort Alina Yu. Babenko
collection DOAJ
description Rationale. It is well known that diabetes mellitus (DM) exacerbates the mechanisms underlying atherosclerosis. Currently, glucagon-like peptide-1 receptor agonists (aGLP-1) have one of the most prominent cardioprotective effects among the antidiabetic agents. However, the treatment with aGLP-1 is effective only in 50-70% of the cases. Taking into account the high cost of these medications, discovery of the predictors of optimal response to treatment is required. Purpose. To identify the predictors of the greater impact of aGLP-1 on HbA1c levels, weight reduction, and improvement in lipid profile. Methods. The study group consisted of 40 patients with type 2 DM (T2DM) and obesity who were treated with aGLP-1. The follow-up period was 24 weeks. Patients’ evaluation was conducted at baseline and after 24 weeks. In addition, it included the assessment of the hormones involved in glucose and lipid metabolism and appetite regulation. Results. Patients who have initially higher BMI (body mass index), glycemia, and triglycerides (TG) had better improvement in these parameters undergoing aGLP-1 treatment. In patients with a BMI loss≥5%, GLP-1 and fasting ghrelin levels were higher and ghrelin level in postnutritional status was lower. The HbA1c levels decreased more intensively in participants with higher GLP-1 levels. TG responders had lower baseline fasting glucose-dependent insulinotropic peptide (GIP) and postprandial ghrelin levels. Conclusion. The evaluation of the glycemic control, lipid profile, and GLP-1, GIP, and ghrelin levels are useable for estimating the expected efficacy of aGLP-1.
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spelling doaj-art-a56a64bf6f124b21b32842eab08d6be72025-08-20T02:20:38ZengWileyJournal of Diabetes Research2314-67452314-67532019-01-01201910.1155/2019/13651621365162Predictors of Effectiveness of Glucagon-Like Peptide-1 Receptor Agonist Therapy in Patients with Type 2 Diabetes and ObesityAlina Yu. Babenko0Daria A. Savitskaya1Yulia A. Kononova2Aleksandra Yu. Trofimova3Anna V. Simanenkova4Elena Yu. Vasilyeva5Evgeny V. Shlyakhto6Almazov National Medical Research Centre, 2 Akkuratova Street, St. Petersburg, 197341, RussiaAlmazov National Medical Research Centre, 2 Akkuratova Street, St. Petersburg, 197341, RussiaAlmazov National Medical Research Centre, 2 Akkuratova Street, St. Petersburg, 197341, RussiaAlmazov National Medical Research Centre, 2 Akkuratova Street, St. Petersburg, 197341, RussiaAlmazov National Medical Research Centre, 2 Akkuratova Street, St. Petersburg, 197341, RussiaAlmazov National Medical Research Centre, 2 Akkuratova Street, St. Petersburg, 197341, RussiaAlmazov National Medical Research Centre, 2 Akkuratova Street, St. Petersburg, 197341, RussiaRationale. It is well known that diabetes mellitus (DM) exacerbates the mechanisms underlying atherosclerosis. Currently, glucagon-like peptide-1 receptor agonists (aGLP-1) have one of the most prominent cardioprotective effects among the antidiabetic agents. However, the treatment with aGLP-1 is effective only in 50-70% of the cases. Taking into account the high cost of these medications, discovery of the predictors of optimal response to treatment is required. Purpose. To identify the predictors of the greater impact of aGLP-1 on HbA1c levels, weight reduction, and improvement in lipid profile. Methods. The study group consisted of 40 patients with type 2 DM (T2DM) and obesity who were treated with aGLP-1. The follow-up period was 24 weeks. Patients’ evaluation was conducted at baseline and after 24 weeks. In addition, it included the assessment of the hormones involved in glucose and lipid metabolism and appetite regulation. Results. Patients who have initially higher BMI (body mass index), glycemia, and triglycerides (TG) had better improvement in these parameters undergoing aGLP-1 treatment. In patients with a BMI loss≥5%, GLP-1 and fasting ghrelin levels were higher and ghrelin level in postnutritional status was lower. The HbA1c levels decreased more intensively in participants with higher GLP-1 levels. TG responders had lower baseline fasting glucose-dependent insulinotropic peptide (GIP) and postprandial ghrelin levels. Conclusion. The evaluation of the glycemic control, lipid profile, and GLP-1, GIP, and ghrelin levels are useable for estimating the expected efficacy of aGLP-1.http://dx.doi.org/10.1155/2019/1365162
spellingShingle Alina Yu. Babenko
Daria A. Savitskaya
Yulia A. Kononova
Aleksandra Yu. Trofimova
Anna V. Simanenkova
Elena Yu. Vasilyeva
Evgeny V. Shlyakhto
Predictors of Effectiveness of Glucagon-Like Peptide-1 Receptor Agonist Therapy in Patients with Type 2 Diabetes and Obesity
Journal of Diabetes Research
title Predictors of Effectiveness of Glucagon-Like Peptide-1 Receptor Agonist Therapy in Patients with Type 2 Diabetes and Obesity
title_full Predictors of Effectiveness of Glucagon-Like Peptide-1 Receptor Agonist Therapy in Patients with Type 2 Diabetes and Obesity
title_fullStr Predictors of Effectiveness of Glucagon-Like Peptide-1 Receptor Agonist Therapy in Patients with Type 2 Diabetes and Obesity
title_full_unstemmed Predictors of Effectiveness of Glucagon-Like Peptide-1 Receptor Agonist Therapy in Patients with Type 2 Diabetes and Obesity
title_short Predictors of Effectiveness of Glucagon-Like Peptide-1 Receptor Agonist Therapy in Patients with Type 2 Diabetes and Obesity
title_sort predictors of effectiveness of glucagon like peptide 1 receptor agonist therapy in patients with type 2 diabetes and obesity
url http://dx.doi.org/10.1155/2019/1365162
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