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Yousef CC, Thomas A, Matar MA, Ghandoura L, Aldossary I, Almuhanna SM, Alhussain F, Al Bisher FB, Aljohani RM, Balubaid AN, Nouh MI, Almurashi A, AlAmoudi R. Liraglutide effects on glycemic control and weight in patients with type 2 diabetes Mellitus: A real-world, observational study and brief narrative review. Diabetes Res Clin Pract 2021; 177:108871. [PMID: 34052248 DOI: 10.1016/j.diabres.2021.108871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 04/06/2021] [Accepted: 05/24/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Glycemic control and weight gain are two essential considerations in the pharmacological management of type 2 diabetes mellitus. Pharmacological agents are effective in lowering blood glucose levels but may result in significant weight gain. Liraglutideeffectively maintains glycemic control while reducingweight. METHODS This is a real-world study and brief narrative review of the effects of liraglutide on glycemic control and weight in adult patients with type 2 diabetes mellitus. The study uses data extracted from the electronic health record of the Ministry of National Guard-Health Affairs. RESULTS In this study of 348 subjects, there was a statistically significant reduction in hemoglobin A1c of 0.9% (P < .0001) and weight of 2.3 kg (P < .0001). The majority (77.3%) were on concomitant insulin.Subjects with a baseline hemoglobin A1c greater than 9% had a significantly greater reduction than those below 9% (-0.7%;P < .0001). Those with a weight more than 100 kg had a significantly greater reduction than those below 100 kg (-0.9 kg;P = .0096). CONCLUSION In this real-world, observational study, liraglutide was shown to be effective in improving glycemic control and reducing weight in adult patients with type 2 diabetes mellitus.
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Affiliation(s)
- Consuela Cheriece Yousef
- Pharmaceutical Care Department, Ministry of the National Guard-Health Affairs, Dammam, Saudi Arabia; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
| | - Abin Thomas
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; Department of Biostatistics and Bioinformatics, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Manar Al Matar
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; Imam Abdulrahman Bin Faisal University, College of Clinical Pharmacy, Dammam, Saudi Arabia
| | - Lama Ghandoura
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; Department of Family Medicine, Ministry of National Guard-Health Affairs, Jeddah, Saudi Arabia
| | - Ibrahim Aldossary
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; Pharmaceutical Care Department, Ministry of National Guard-Health Affairs, Al Ahsa, Saudi Arabia
| | - Sarah Musa Almuhanna
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; Imam Abdulrahman Bin Faisal University, College of Clinical Pharmacy, Dammam, Saudi Arabia
| | - Fatimah Alhussain
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; Imam Abdulrahman Bin Faisal University, College of Clinical Pharmacy, Dammam, Saudi Arabia
| | - Fatmh Bisher Al Bisher
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; Imam Abdulrahman Bin Faisal University, College of Clinical Pharmacy, Dammam, Saudi Arabia
| | - Raneem Mohammad Aljohani
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; Ibn Sina National College, College of Clinical Pharmacy, Jeddah, Saudi Arabia
| | - Alya Najeeb Balubaid
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; Ibn Sina National College, College of Clinical Pharmacy, Jeddah, Saudi Arabia
| | - Mahmoud Ismail Nouh
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; Umm Al-Qura University, College of Pharmacy, Makkah, Saudi Arabia
| | - Abdulhalim Almurashi
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; General Directorate of Health Affairs, Department of Family Medicine, Madinah, Saudi Arabia
| | - Reem AlAmoudi
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; Department of Medicine, Ministry of National Guard-Health Affairs, Jeddah, Saudi Arabia
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Hanif W, Ali SN, Bellary S, Patel V, Farooqi A, Karamat MA, Saeed M, Sivaprasad S, Patel K, Khunti K. Pharmacological management of South Asians with type 2 diabetes: Consensus recommendations from the South Asian Health Foundation. Diabet Med 2021; 38:e14497. [PMID: 33301625 DOI: 10.1111/dme.14497] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 10/27/2020] [Accepted: 11/30/2020] [Indexed: 12/27/2022]
Abstract
South Asians constitute approximately 1.6 billion people from the Indian subcontinent, comprising Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan and Sri Lanka; and make up the largest diaspora globally. Compared to the White European population, this group is at a higher risk of developing type 2 diabetes along with cardiovascular, renal and eye complications. Over the recent years, a number of new therapies for type 2 diabetes have become available for which cardiovascular outcome trials (CVOTs) have been published. The recent ADA/EASD consensus guidelines on diabetes, pre-diabetes and cardiovascular diseases' offer a transitional shift in type 2 diabetes management. The new consensus recommendations are based on recent CVOTs, many of which had a representation of South Asian cohorts. In light of this new evidence, there is urgent need for an integrated, evidence-based, cost-effective and individualised approach specific for South Asians. This review takes into consideration the evidence from these CVOTs and provides best practice recommendations for optimal management of South Asian people with type 2 diabetes, alongside the previously published consensus report from South Asian Health Foundation in 2014 [1].
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Affiliation(s)
- Wasim Hanif
- Diabetes & Endocrinology, CSL Diabetes, University Hospitals of Birmingham, South Asian Health Foundation, Birmingham, UK
| | - Sarah N Ali
- Diabetes and Endocrinology, Royal Free London NHS Foundation Trust, Diabetes Working Group, South Asian Health Foundation, Birmingham, UK
| | - Srikanth Bellary
- School of Life and Health Sciences, Aston University, University Hospitals Birmingham, Birmingham, UK
| | - Vinod Patel
- Diabetes and Clinical Skills, Warwick Medical School, University of Warwick, Coventry, UK
- South Asian Health Foundation, Birmingham, UK
| | - Azhar Farooqi
- East Leicester Medical Practice, Leicester City CCG, BME Centre for Health, ARC East Midlands, Leicester, UK
| | - Muhammad Ali Karamat
- Diabetes and Endocrinology, UHB TPD Diabetes and Endocrinology, Health Education, Birmingham, UK
| | - Mujahid Saeed
- Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham, University of Birmingham, Birmingham, UK
| | - Sobha Sivaprasad
- NIHR Moorfields Biomedical Research Centre and UCL Institute of Ophthalmology, London, UK
| | - Kiran Patel
- South Asian Health Foundation, Birmingham, UK
- University Hospitals Coventry & Warwickshire NHS Trust, Warwick Medical School, University of Warwick, Coventry University, Coventry, UK
| | - Kamlesh Khunti
- South Asian Health Foundation, Birmingham, UK
- Primary Care Diabetes & Vascular Medicine, Diabetes Research Centre and The Centre for Black Minority Health, University of Leicester, Leicester, UK
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Rashid MO, Jabeen S, Khoja A, Islam N. Efficacy of Liraglutide in clinical practice: Single centre experience. Pak J Med Sci 2020; 36:432-437. [PMID: 32292448 PMCID: PMC7150369 DOI: 10.12669/pjms.36.3.358] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background and Objective: GLP-one receptor agonists are amongst the unique antidiabetes medications that have significant metabolic and cardiovascular benefits in addition to glucose lowering effect. To best of our knowledge, there is no published data on efficacy of liraglutide use among Pakistani population.Our objective was to ascertain the efficacy of liraglutide use among type two diabetes patients. Methods: This retrospective study was conducted at the Endocrinology Clinics of Aga Khan University Hospital (AKUH) Karachi, Pakistan during the period from July 01, 2016 to 30th June, 2017. Liraglutide was prescribed to 68 obese type two diabetes patients with uncontrolled diabetes taking more than one oral medication ± insulin. Starting dose of Liraglutide was 0.6 mg, which was increased to 1.2 mg after 1-2 weeks with further increment to 1.8 mg/day based on tolerance and individual patient preference. Dose of other diabetes medications was adjusted according to clinical judgment whereas Dipeptidyl peptidase-4(DPP-4) inhibitors were discontinued. Results: Mean age of cohort was 55 years (SD=10.94 years) with median body mass index of 36.45 kg/m2 and majority (57.35%) were on a dose of 1.2 mg of Liraglutide per day. Median HbA1c reduced to 7.50% and 7.40% at three months and six months respectively vs 8.45% at baseline. Mean reduction in weight after three month was two kilograms and at six months, it was 1.38 kilograms respectively. Conclusion: Liraglutide as add on therapy demonstrated favourable HbA1c and weight reduction in obese uncontrolled type two Diabetes Pakistani subjects.
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Affiliation(s)
- Muhammad Owais Rashid
- M. Owais Rashid MBBS, FCPS (Medicine), FCPS (Endocrinology), Consultant Endocrinologist, Section of Endocrinology, Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Sumerah Jabeen
- Sumerah Jabeen, FCPS (Medicine). Fellowship in Diabetes & Endocrinology, Aga Khan University Hospital, Karachi, Pakistan
| | - Adeel Khoja
- Adeel Khoja, MBBS. Senior Instructor Research, Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Najmul Islam
- Najmul Islam, MBBS, FRCP. Consultant Endocrinologist, Section Head Endocrinology, Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
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Kalra S, Das AK, Sahay RK, Baruah MP, Tiwaskar M, Das S, Chatterjee S, Saboo B, Bantwal G, Bhattacharya S, Priya G, Chawla M, Brar K, Raza SA, Aamir AH, Shrestha D, Somasundaram N, Katulanda P, Afsana F, Selim S, Naseri MW, Latheef A, Sumanatilleke M. Consensus Recommendations on GLP-1 RA Use in the Management of Type 2 Diabetes Mellitus: South Asian Task Force. Diabetes Ther 2019; 10:1645-1717. [PMID: 31359367 PMCID: PMC6778554 DOI: 10.1007/s13300-019-0669-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Indexed: 12/17/2022] Open
Abstract
The advent of incretin mimetics such as glucagon-like peptide-1 receptor agonists (GLP-1 RAs) has enriched the armamentarium for diabetes management owing to their glycaemic as well as extra-glycaemic benefits. The approval status and availability of this class of drugs vary widely across the globe. Being a relatively newer class of drug with numerous benefits, several national and international guidelines are working towards addressing clinical questions pertaining to the optimal use of GLP-1 RAs for the management of diabetes. Although the newer class of drugs are associated with significant benefits such as patient-centric approach, these drugs demand the providers to be vigilant and knowledgeable about the medication. The South Asian population is at higher risk of type 2 diabetes mellitus (T2DM) because of their genetic predisposition and lifestyle changes. Hence, prevention and management of T2DM and its associated complications in this population are of paramount importance. The current report aims to present an overview of current knowledge on GLP-1 RAs based on pragmatic review of the available clinical evidence. In addition, this report is a consensus of expert endocrinologists representing South Asian countries including India, Pakistan, Bangladesh, Nepal, Sri Lanka, Afghanistan and the Maldives on essential recommendations related to the use of GLP-1 RAs in a real-world scenario.
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Affiliation(s)
| | - Ashok Kumar Das
- Pondicherry Institute of Medical Sciences, Pondicherry, India
| | | | | | | | - Sambit Das
- Hi Tech Medical College and Hospital, Bhubaneshwar, India
| | | | | | | | | | | | | | | | - Syed Abbas Raza
- Shaukat Khanum Memorial Cancer Hospital and Research Centre and National Defence Hospital, Lahore, Pakistan
| | | | | | | | | | | | - Shahjada Selim
- Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh
| | | | - Ali Latheef
- Department of Medicine, Indra Gandhi Hospital, Male, Maldives
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Abstract
Liraglutide is an effective drug for the treatment of type 2 diabetes mellitus (T2DM). The aim of this review is to collate evidence on the real-world clinical effectiveness of liraglutide from the published Indian studies. A review of publications was conducted to identify observational studies that assessed the effectiveness of liraglutide among Indian T2DM. Total ten publications were retrieved and these observational studies are compared with the results of the liraglutide randomized controlled trial (RCT) program (Liraglutide Effect and Action in Diabetes [LEAD]). Liraglutide therapy demonstrated HbA1c reduction in the Indian population up to 2.26% and 2.54%, over 24 and 52 weeks, respectively. Among the LEAD trials, the HbA1c reduction at 24 weeks was maximum in LEAD-4 with 1.5% reduction at both doses used (1.2 and 1.8 mg) and up to 1.14% in LEAD-3 with a dose of 1.8 mg. The weight loss among Indian subjects was generally around 5 kg or more with maximum weight loss of 8.6 kg over 24 weeks. The maximal weight loss in LEAD studies was less than 3 kg with an exception of 3.24 kg in LEAD-6. In over 52 weeks of liraglutide therapy among Indian subjects, mean weight loss was 7.4 kg, which was 3.5 times more than of LEAD program. Two Indian observational studies also demonstrated significant weight loss among nondiabetic obese subjects at a much lower than that of 3 mg anti-obesity dose. Gastrointestinal (GI) events are the commonly reported adverse events with Indian studies as well as LEAD program. Liraglutide therapy produces better glycemic control and more weight loss among Indian T2DM subjects compared with RCTs conducted in western population with almost similar adverse consequences.
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Affiliation(s)
- Majumder Anirban
- Department of Endocrinology, KPC Medical College, Jadavpur, Kolkata, West Bengal, India
| | | | - Sanyal Debmalya
- Department of Endocrinology, KPC Medical College, Jadavpur, Kolkata, West Bengal, India
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Tiwari J, Gupta G, Dahiya R, Pabreja K, Kumar Sharma R, Mishra A, Dua K. Recent update on biological activities and pharmacological actions of liraglutide. EXCLI JOURNAL 2017; 16:742-747. [PMID: 28827989 PMCID: PMC5547392 DOI: 10.17179/excli2017-323] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Accepted: 05/03/2017] [Indexed: 12/23/2022]
Affiliation(s)
- Juhi Tiwari
- School of Pharmacy, Jaipur National University, Jagatpura 302017, Jaipur, India
| | - Gaurav Gupta
- School of Pharmacy, Jaipur National University, Jagatpura 302017, Jaipur, India.,School of Medicine and Public Health, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Rajiv Dahiya
- Laboratory of Peptide Research and Development, School of Pharmacy, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad & Tobago, West Indies
| | - Kavita Pabreja
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Rakesh Kumar Sharma
- School of Pharmacy, Suresh Gyan Vihar University, Jagatpura 302017, Jaipur, India
| | - Anurag Mishra
- School of Pharmacy, Suresh Gyan Vihar University, Jagatpura 302017, Jaipur, India
| | - Kamal Dua
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Sydney, NSW 2007, Australia.,School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, NSW 2308, Australia.,School of Pharmaceutical Sciences, Shoolini University, Solan, Himachal Pradesh, 173229, India
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