Article Text

Type 1 Diabetes Treatment Beyond Insulin
  1. Lindsay B. Harrison, MD,
  2. Pablo F. Mora, MD,
  3. Gregory O. Clark, MD,
  4. Ildiko Lingvay, MD, MPH, MSCS
  1. From the Division of Endocrinology, Diabetes, and Metabolism, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX.
  1. Received August 27, 2012, and in revised form October 5, 2012.
  2. Accepted for publication October 5, 2012.
  3. Reprints: Lindsay Harrison, MD, Division of Endocrinology, Diabetes, and Metabolism, Department of Internal Medicine, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390-8857. E-mail: Lindsay.Harrison{at}
  4. No funding was received for this work.
  5. The abstract of this paper was published in the American Diabetes Association’s 72nd Scientific Sessions (June 8–12, 2012 in Philadelphia, PA) June 2012 supplement to the journal Diabetes as abstract number 2369-PO.
  6. PM serves on Novo Nordisk, Inc speaker’s bureau and scientific advisory board. IL serves on the scientific advisory board of Novo Nordisk, Inc.

Role of GLP-1 Analogs


Objective To observe the efficacy and safety of glucagonlike peptide-1 (GLP-1) analogs in type 1 diabetes in a real-life medical practice setting.

Methods We performed a retrospective chart review of patients with type 1 diabetes initiated on a GLP-1 analog and with at least one follow-up visit at more than 4 weeks.

Results We identified 11 patients who were initiated on a GLP-1 analog and had a follow-up visit between 4 and 13 weeks (mean (SD) follow-up 10 ± 3 weeks; age 36.5 ± 16.4 years; duration of diabetes 17.3 ± 9.3 years; all on insulin pump therapy; all started on liraglutide). Seven of these patients had a second follow-up visit at approximately 20 weeks. By 10 weeks, there was a significant decrease in weight (4.2% of total body weight), total daily insulin dose (19.2%, of which 14.0% basal and 24.1% bolus), and mean (SD) insulin units/kg (0.57 [0.17] to 0.48 [0.17] units/kg). Hemoglobin A1c was significantly decreased (7.4 [0.7%] to 7.0 [0.7%], P = 0.02) without an increase in hypoglycemia. These effects were sustained at 20 weeks. Nausea was a common adverse effect and lead to drug discontinuation in 4 of 11 patients.

Conclusions Patients with long-standing type 1 diabetes can achieve weight loss and improved glycemic control on less insulin without an increase in hypoglycemia when liraglutide is added to insulin therapy.

Key Words
  • type 1 diabetes
  • GLP-1
  • glucagonlike peptide
  • liraglutide
  • incretin

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