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Samuels SL, Chajecki A, Hu P, Kayser M, Weyman K, Pan B, Brown EA, Van Name M, Wolf RM. Real-world use of glucagon-like peptide-1 receptor agonists in youth with type 2 diabetes is associated with short-term improvements in HbA1c. Diabetes Obes Metab 2024; 26:1305-1313. [PMID: 38229444 DOI: 10.1111/dom.15430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 12/04/2023] [Accepted: 12/07/2023] [Indexed: 01/18/2024]
Abstract
AIM To assess the short-term, real-world use and effectiveness of glucagon-like peptide-1 receptor agonist (GLP-1RA) medications in the management of type 2 diabetes (T2D) in a diverse cohort of youth. METHODS This multicentre retrospective study analysed youth prescribed a GLP-1RA for the management of T2D at two academic paediatric diabetes centres prior to June 2022. Change in HbA1c and insulin use from baseline to first (median 91 days) and second (median 190 days) follow-up were evaluated for those taking a GLP-1RA. Multivariable linear mixed effects models adjusting for baseline sex, age, race/ethnicity, insurance, insulin regimen, metformin regimen, GLP-1RA dosing frequency and the body mass index Z-score (BMI-Z) examined the change in HbA1c for participants for up to 6 months after baseline. RESULTS A total of 136 patients with T2D (median age 16.1 [interquartile range 13.9-18.0] years, 54% female, 56% non-Hispanic Black, 24% Hispanic, 77% with public insurance) were prescribed GLP-1RAs and taking them at first or second follow-up. Median HbA1c decreased from 7.9% to 7.6% (P < .001) at a median follow-up of 91 days (n = 109) and, among those with HbA1c available at baseline and second follow-up (n = 83), from 8.4% to 7.4%. The proportion of patients prescribed insulin decreased from baseline to the first follow-up visit (basal 69% to 60% [P = .008], prandial 46% to 38% [P = .03]). In multivariable analysis, there was a mean decrease in HbA1c by 0.09 percentage points per month (P = .005, 95% confidence interval -0.15, -0.03). CONCLUSIONS Real-world use of GLP-1RAs in youth with T2D is associated with decreased HbA1c levels, despite challenges with access and adherence. GLP-1RA treatment may reduce insulin doses for youth with T2D.
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Affiliation(s)
- Stephanie L Samuels
- Department of Pediatrics, Division of Endocrinology and Diabetes, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Anastasia Chajecki
- Department of Pediatrics, Division of Endocrinology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Pamela Hu
- Department of Pediatrics, Division of Endocrinology and Diabetes, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Michelle Kayser
- Department of Pediatrics, Division of Endocrinology and Diabetes, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Kate Weyman
- Department of Pediatrics, Division of Endocrinology and Diabetes, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Bernard Pan
- Department of Pediatrics, Division of Endocrinology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Elizabeth A Brown
- Department of Pediatrics, Division of Endocrinology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Michelle Van Name
- Department of Pediatrics, Division of Endocrinology and Diabetes, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Risa M Wolf
- Department of Pediatrics, Division of Endocrinology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Long Y, Zhang Y. Liraglutide combined with metformin treatment for obese people with type 2 diabetes mellitus: a systematic review and meta-analysis. Ir J Med Sci 2023; 192:2809-2814. [PMID: 37036569 DOI: 10.1007/s11845-023-03337-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 03/03/2023] [Indexed: 04/11/2023]
Abstract
AIM To assess clinical efficacy and safety of liraglutide combined with metformin (LMT) in obese patients with type 2 diabetes (ODP) by conducting a meta-analysis of randomized controlled trials (RCTs). METHODS PubMed, EMBASE, Cochrane Library, CNKI, CNKI, and VIP databases were systematically searched for randomized controlled trials (RCTs) through January 1, 2015 to investigate the effectiveness of liraglutide combined with metformin treatment (LMT) in obesity patients with type 2 diabetes (ODP). Meta-analysis (using generic inverse variance random effects model) was performed when there were two or more studies reporting on the same evaluation indicators. Review Manager V.5.3 was used to perform the meta-analysis. RESULTS A total of 1289 participants from 15 RCTs were selected for the final meta-analysis. A synthesis of current evidence of LMT for treating ODP was provided in this protocol. CONCLUSION This review will offer insights for future research and provide reference for LMT treatment for ODP.
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Affiliation(s)
- Yang Long
- Department of Pharmacy, Jintang First People's Hospital (West China Hospital Sichuan University Jintang Hospital), Chengdu, 610041, People's Republic of China
| | - Yuxi Zhang
- Affiliated Hospital of Sichuan Nursing Vocational College, The Third People's Hospital of Sichuan Province, Chengdu, 610199, People's Republic of China.
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Ivić V, Zjalić M, Blažetić S, Fenrich M, Labak I, Scitovski R, Szűcs KF, Ducza E, Tábi T, Bagamery F, Szökő É, Vuković R, Rončević A, Mandić D, Debeljak Ž, Berecki M, Balog M, Seres-Bokor A, Sztojkov-Ivanov A, Hajagos-Tóth J, Gajović S, Imširović A, Bakula M, Mahiiovych S, Gaspar R, Vari SG, Heffer M. Elderly rats fed with a high-fat high-sucrose diet developed sex-dependent metabolic syndrome regardless of long-term metformin and liraglutide treatment. Front Endocrinol (Lausanne) 2023; 14:1181064. [PMID: 37929025 PMCID: PMC10623428 DOI: 10.3389/fendo.2023.1181064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 09/25/2023] [Indexed: 11/07/2023] Open
Abstract
Aim/Introduction The study aimed to determine the effectiveness of early antidiabetic therapy in reversing metabolic changes caused by high-fat and high-sucrose diet (HFHSD) in both sexes. Methods Elderly Sprague-Dawley rats, 45 weeks old, were randomized into four groups: a control group fed on the standard diet (STD), one group fed the HFHSD, and two groups fed the HFHSD along with long-term treatment of either metformin (HFHSD+M) or liraglutide (HFHSD+L). Antidiabetic treatment started 5 weeks after the introduction of the diet and lasted 13 weeks until the animals were 64 weeks old. Results Unexpectedly, HFHSD-fed animals did not gain weight but underwent significant metabolic changes. Both antidiabetic treatments produced sex-specific effects, but neither prevented the onset of prediabetes nor diabetes. Conclusion Liraglutide vested benefits to liver and skeletal muscle tissue in males but induced signs of insulin resistance in females.
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Affiliation(s)
- Vedrana Ivić
- Department of Medical Biology and Genetics, Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Milorad Zjalić
- Department of Medical Biology and Genetics, Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Senka Blažetić
- Department of Biology, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Matija Fenrich
- Department of Medical Biology and Genetics, Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Irena Labak
- Department of Biology, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Rudolf Scitovski
- School of Applied Mathematics and Computer Science, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Kálmán Ferenc Szűcs
- Department of Pharmacology and Pharmacotherapy, Albert Szent-Györgyi Medical School, Interdisciplinary Excellence Centre, University of Szeged, Szeged, Hungary
| | - Eszter Ducza
- Department of Pharmacodynamics and Biopharmacy, Faculty of Pharmacy, University of Szeged, Szeged, Hungary
| | - Tamás Tábi
- Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary
| | - Fruzsina Bagamery
- Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary
| | - Éva Szökő
- Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary
| | - Rosemary Vuković
- Department of Biology, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Alen Rončević
- Department of Medical Biology and Genetics, Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
- Department of Neurosurgery, Osijek University Hospital, Osijek, Croatia
| | - Dario Mandić
- Clinical Institute of Laboratory Diagnostics, Osijek University Hospital, Osijek, Croatia
- Department of Medical Chemistry, Biochemistry and Clinical Chemistry, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Željko Debeljak
- Clinical Institute of Laboratory Diagnostics, Osijek University Hospital, Osijek, Croatia
- Department of Pharmacology, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Monika Berecki
- Department of Medical Biology and Genetics, Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Marta Balog
- Department of Medical Biology and Genetics, Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Adrienn Seres-Bokor
- Department of Pharmacodynamics and Biopharmacy, Faculty of Pharmacy, University of Szeged, Szeged, Hungary
| | - Anita Sztojkov-Ivanov
- Department of Pharmacodynamics and Biopharmacy, Faculty of Pharmacy, University of Szeged, Szeged, Hungary
| | - Judit Hajagos-Tóth
- Department of Pharmacology and Pharmacotherapy, Albert Szent-Györgyi Medical School, Interdisciplinary Excellence Centre, University of Szeged, Szeged, Hungary
| | - Srećko Gajović
- Croatian Institute for Brain Research, and BIMIS - Biomedical Research Institute Šalata, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Alen Imširović
- Department of Medical Biology and Genetics, Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Marina Bakula
- Department of Clinical Pathology and Forensic Medicine, Osijek University Hospital, Osijek, Croatia
| | - Solomiia Mahiiovych
- Department of Therapy № 1 and Medical Diagnostics, Hematology and Transfusiology, Faculty of Postgraduate Education, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
| | - Robert Gaspar
- Department of Pharmacology and Pharmacotherapy, Albert Szent-Györgyi Medical School, Interdisciplinary Excellence Centre, University of Szeged, Szeged, Hungary
| | - Sandor G. Vari
- Cedars-Sinai Medical Center, International Research and Innovation in Medicine Program, Los Angeles, CA, United States
| | - Marija Heffer
- Department of Medical Biology and Genetics, Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
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Berman C, Vidmar AP, Chao LC. Glucagon-like Peptide-1 Receptor Agonists for the Treatment of Type 2 Diabetes in Youth. TOUCHREVIEWS IN ENDOCRINOLOGY 2023; 19:38-45. [PMID: 37313232 PMCID: PMC10258616 DOI: 10.17925/ee.2023.19.1.38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 04/20/2023] [Indexed: 06/15/2023]
Abstract
Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have gained traction for the management of type 2 diabetes and obesity. Unlike several classes of antidiabetic medications that contribute to weight gain, GLP-1RAs not only reduce haemoglobin A1c, but also promote weight loss. While there is a large body of evidence supporting its safety and efficacy in adults, paediatric clinical trial data have only emerged in recent years. This review will discuss the limited treatment options for paediatric type 2 diabetes and the mechanism of action of GLP-1RAs as it pertains to physiological pathways relevant for type 2 diabetes, obesity and their related comorbidities. The outcomes of paediatric trials evaluating liraglutide, exenatide, semaglutide and dulaglutide in paediatric type 2 diabetes and obesity will be closely examined, including differences compared with adult studies. Finally, potential barriers and strategies to expanding GLP-1RA access in adolescents will be discussed. Future studies are needed to determine if the cardio-and renal-protective benefits of GLP-1RAs apply to youth-onset type 2 diabetes.
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Affiliation(s)
- Casey Berman
- Division of Endocrinology, Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, CA, USA
| | - Alaina P Vidmar
- Division of Endocrinology, Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, CA, USA
- Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
| | - Lily C Chao
- Division of Endocrinology, Department of Pediatrics, Children’s Hospital Los Angeles, Los Angeles, CA, USA
- Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
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Hao S, Umpierrez GE, Vellanki P. Intervention with Therapeutic Agents, Understanding the Path to Remission to Type 2 Diabetes: Part 2. Endocrinol Metab Clin North Am 2023; 52:39-47. [PMID: 36754496 PMCID: PMC10158502 DOI: 10.1016/j.ecl.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Type 2 diabetes is characterized by progressive decline in pancreatic β-cell function. Newer agents, such as glucagon-like peptide-1 receptor agonist (GLP-1RA) and dual incretin agonists, can augment β-cell function and delay the need for additional antihyperglycemics. However, the effect on β-cell function ceases after stopping the medications. When combined with intensive lifestyle modifications, higher doses of GLP-1RA than those used for diabetes treatment can be used to induce weight loss. More research is needed on whether the weight loss achieved with GLP1-RA can be sustained after stopping medication and in turn can sustain diabetes remission.
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Affiliation(s)
- Shuai Hao
- Division of Pediatric Endocrinology, Children's Healthcare of Atlanta, Emory University School of Medicine, 1400 Tullie Road Northeast, Atlanta, GA 30329, USA
| | - Guillermo E Umpierrez
- Division of Endocrinology, Metabolism & Lipids, Emory University School of Medicine, 69 Jesse Hill Jr Drive Southeast, Glenn Building, Atlanta, GA 30303, USA
| | - Priyathama Vellanki
- Division of Endocrinology, Metabolism & Lipids, Emory University School of Medicine, 69 Jesse Hill Jr Drive Southeast, Glenn Building, Atlanta, GA 30303, USA.
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6
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Risk Factors, Clinical Consequences, Prevention, and Treatment of Childhood Obesity. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121975. [PMID: 36553418 PMCID: PMC9776766 DOI: 10.3390/children9121975] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 12/03/2022] [Accepted: 12/10/2022] [Indexed: 12/23/2022]
Abstract
Obesity might adversely affect the health and well-being of children and their families. Childhood obesity has crucial implications for health, both during childhood and as they age. It is highly associated with many acute problems and is commonly present during childhood, making visits and hospital admissions polarized in this group of children. The problems that may affect these children can be medical, such as asthma, chronic inflammation, orthopedic abnormalities, liver disease, diabetes mellitus or dyslipidemia. Long-term consequences of cardiovascular risk factors, the persistence of obesity and premature mortality are common among adults who had obesity during their early lives. Additionally, they could also suffer from psychological issues, such as low self-esteem, which puts them at risk of a much more serious psychosocial problem that may lead to depression, as well as a disruption in educational achievements and social relationships. A healthy diet, physical activity, adequate sleep, and limited screen time are all preventive measures that should be implemented at the family and community levels, preferably through well-structured programs. Furthermore, pharmacological management of childhood obesity is limited and only used after non-pharmacological interventions have failed or in the late stages of obesity. However, recent guidelines advocate the early use of medical interventions. Approved pharmacotherapeutic options include orlistat, phentermine/topiramate combination and liraglutide. There are several other options approved primarily for other specific forms of obesity or for other indications, including setmelanotide, metformin, lisdexamfetamine, zonisamide and fluoxetine. Bariatric surgery is a safe and effective option in cases with extreme obesity and comorbidities considering the need for long-term monitoring and support for cases and their families post-surgery. This review aims to discuss and highlight the recent evidence regarding risk factors, clinical consequences, prevention, and treatment of childhood obesity.
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Gaeta F, Conti V, Pepe A, Vajro P, Filippelli A, Mandato C. Drug dosing in children with obesity: a narrative updated review. Ital J Pediatr 2022; 48:168. [PMID: 36076248 PMCID: PMC9454408 DOI: 10.1186/s13052-022-01361-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 08/30/2022] [Indexed: 11/16/2022] Open
Abstract
Childhood obesity and its associated comorbidities are highly prevalent diseases that may add to any other possible health problem commonly affecting the pediatric age. Uncertainties may arise concerning drug dosing when children with obesity need pharmacologic therapies. In general, in pediatric practice, there is a tendency to adapt drug doses to a child’s total body weight. However, this method does not consider the pharmacological impact that a specific drug can have under a two-fold point of view, that is, across various age and size groups as well. Moreover, there is a need for a therapeutic approach, as much as possible tailored considering relevant interacting aspects, such as modification in metabolomic profile, drug pharmacokinetics and pharmacodynamics. Taking into account the peculiar differences between children with overweight/obesity and those who are normal weight, the drug dosage in the case of obesity, cannot be empirically determined solely by the per kg criterion. In this narrative review, we examine the pros and cons of several drug dosing methods used when dealing with children who are affected also by obesity, focusing on specific aspects of some of the drugs most frequently prescribed in real-world practice by general pediatricians and pediatric subspecialists.
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Affiliation(s)
- Francesca Gaeta
- Pediatrics Section, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, 84081, Baronissi, Salerno, Italy
| | - Valeria Conti
- Pharmacology Section, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, 84081, Baronissi, Salerno, Italy
| | - Angela Pepe
- Pediatrics Section, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, 84081, Baronissi, Salerno, Italy
| | - Pietro Vajro
- Pediatrics Section, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, 84081, Baronissi, Salerno, Italy
| | - Amelia Filippelli
- Pharmacology Section, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, 84081, Baronissi, Salerno, Italy
| | - Claudia Mandato
- Pediatrics Section, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, 84081, Baronissi, Salerno, Italy.
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Bensignor MO, Wolf JM, Rudser KD, Kelly AS, Arslanian S. Glucagon-like peptide-1 receptor agonist prescribing patterns in adolescents with type 2 diabetes. Diabetes Obes Metab 2022; 24:1380-1384. [PMID: 35491535 PMCID: PMC9177669 DOI: 10.1111/dom.14681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/18/2022] [Accepted: 03/01/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Megan O. Bensignor
- Center for Pediatric Obesity Medicine, Department of PediatricsUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Jack M. Wolf
- Division of BiostatisticsUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Kyle D. Rudser
- Division of BiostatisticsUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Aaron S. Kelly
- Center for Pediatric Obesity Medicine, Department of PediatricsUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Silva Arslanian
- Center for Pediatric Research in Obesity and Metabolism, Division of Pediatric Endocrinology and MetabolismUPMC Children's Hospital, University of PittsburghPittsburghPennsylvaniaUSA
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9
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Bensignor MO, Kelly AS, Arslanian S. Anti-obesity pharmacotherapy for treatment of pediatric type 2 diabetes: Review of the literature and lessons learned from adults. Front Endocrinol (Lausanne) 2022; 13:1043650. [PMID: 36387846 PMCID: PMC9647073 DOI: 10.3389/fendo.2022.1043650] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 10/13/2022] [Indexed: 12/01/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) in adolescents is a more rapidly progressive disease, associated with earlier and higher rates of microvascular complications than in adults. As obesity is a significant risk factor for T2DM development and progression, the American Diabetes Association (ADA) recommends anti-obesity medications (AOMs) as adjuvant therapy for adults with both T2DM and overweight/obesity. In adults, the addition of AOMs to a diabetes regimen can improve glycemic control, reduce weight, and decrease anti-diabetes medication use. The ADA recommends considering bariatric surgery for adolescents with T2DM who have a BMI >35 kg/m2, but did not mention the use of AOMs in their 2022 updated guidelines. Currently, there are three FDA-approved AOMs available for chronic use in adolescents with obesity. Other medications are used in an "off-label" fashion for appetite suppression and BMI reduction. As additional AOMs are being developed and FDA-approved for the pediatric population, new treatment options with novel mechanisms of action will become available for adolescents with T2DM and obesity. In this review, we will discuss the evidence for the use of AOMs in the treatment of T2DM in adolescents, including lessons learned from the adult T2DM literature.
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Affiliation(s)
- Megan O. Bensignor
- Center for Pediatric Obesity Medicine, Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States
- *Correspondence: Megan O. Bensignor,
| | - Aaron S. Kelly
- Center for Pediatric Obesity Medicine, Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States
| | - Silva Arslanian
- Center for Pediatric Research in Obesity and Metabolism, Division of Pediatric Endocrinology and Metabolism, University of Pittsburgh Medical Center (UPMC) Children’s Hospital, University of Pittsburgh, Pittsburgh, PA, United States
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10
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Bensignor MO, Bomberg EM, Bramante CT, Divyalasya TVS, Hale PM, Ramesh CK, Rudser KD, Kelly AS. Effect of liraglutide treatment on body mass index and weight parameters in children and adolescents with type 2 diabetes: Post hoc analysis of the ellipse trial. Pediatr Obes 2021; 16:e12778. [PMID: 33634589 PMCID: PMC8277686 DOI: 10.1111/ijpo.12778] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 01/06/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Weight loss in children and adolescents with type 2 diabetes (T2D) is associated with improved glycaemic control. OBJECTIVES To assess the effects of liraglutide vs placebo on body mass index (BMI) and weight parameters in children and adolescents with T2D using data from the ellipse trial (NCT01541215). METHODS The ellipse trial randomized participants (10-<17 years old, BMI >85th percentile, T2D, glycated haemoglobin [HbA1c ] 7.0%-11.0% [if diet- and exercise-treated] or 6.5% to 11.0% [if treated with metformin, basal insulin or both]) to liraglutide or placebo. This post-hoc analysis evaluated changes from baseline to weeks 26 and 52 in absolute BMI, percent change in BMI and other weight-related parameters. Changes were assessed by liraglutide overall (all doses) and liraglutide by dose (0.6, 1.2 and 1.8 mg/day) vs placebo using a pattern mixture model of observed data, with missing observations imputed from each treatment group. RESULTS In total, 134 participants were included. There were statistically significant differences between groups in certain parameters, including absolute BMI (estimated treatment difference [ETD] -0.89 kg/m2 ; 95% confidence interval [CI] -1.71,-0.06) and percent change in BMI (ETD -2.73%; 95% CI -5.15,-0.30) at week 52, but none at week 26. Dose-dependent effects were not observed for liraglutide vs placebo for all BMI/weight parameters. CONCLUSIONS Compared with placebo, liraglutide was associated with statistically significant reductions in BMI/weight parameters at week 52, but not week 26, in children and adolescents with T2D.
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Affiliation(s)
- Megan O. Bensignor
- Department of PediatricsUniversity of Minnesota Medical SchoolMinneapolisMinnesotaUSA,Center for Pediatric Obesity MedicineUniversity of Minnesota Medical SchoolMinneapolisMinnesotaUSA
| | - Eric M. Bomberg
- Department of PediatricsUniversity of Minnesota Medical SchoolMinneapolisMinnesotaUSA,Center for Pediatric Obesity MedicineUniversity of Minnesota Medical SchoolMinneapolisMinnesotaUSA
| | - Carolyn T. Bramante
- Center for Pediatric Obesity MedicineUniversity of Minnesota Medical SchoolMinneapolisMinnesotaUSA,Division of General Internal MedicineUniversity of Minnesota Medical SchoolMinneapolisMinnesotaUSA
| | | | | | | | - Kyle D. Rudser
- Center for Pediatric Obesity MedicineUniversity of Minnesota Medical SchoolMinneapolisMinnesotaUSA,Division of BiostatisticsUniversity of Minnesota School of Public HealthMinneapolisMinnesotaUSA
| | - Aaron S. Kelly
- Department of PediatricsUniversity of Minnesota Medical SchoolMinneapolisMinnesotaUSA,Center for Pediatric Obesity MedicineUniversity of Minnesota Medical SchoolMinneapolisMinnesotaUSA
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11
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Moon S, Lee J, Chung HS, Kim YJ, Yu JM, Yu SH, Oh CM. Efficacy and Safety of the New Appetite Suppressant, Liraglutide: A Meta-Analysis of Randomized Controlled Trials. Endocrinol Metab (Seoul) 2021; 36:647-660. [PMID: 34139800 PMCID: PMC8258332 DOI: 10.3803/enm.2020.934] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 04/16/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Obesity is a chronic disease associated with metabolic diseases such as diabetes and cardiovascular disease. Since the U.S. Food and Drug Administration approved liraglutide as an anti-obesity drug for nondiabetic patients in 2014, it has been widely used for weight control in overweight and obese people. This study aimed to systematically analyze the effects of liraglutide on body weight and other cardiometabolic parameters. METHODS We investigated articles from PubMed, EMBASE, and the Cochrane Library to search randomized clinical trials that examined body weight changes with liraglutide treatment. RESULTS We included 31 studies with 8,060 participants for this meta-analysis. The mean difference (MD) between the liraglutide group and the placebo group was -4.19 kg (95% confidence interval [CI], -4.84 to -3.55), with a -4.16% change from the baseline (95% CI, -4.90 to -3.43). Liraglutide treatment correlated with a significantly reduced body mass index (MD: -1.55; 95% CI, -1.76 to -1.34) and waist circumference (MD: -3.11 cm; 95% CI, -3.59 to -2.62) and significantly decreased blood pressure (systolic blood pressure, MD: -2.85 mm Hg; 95% CI, -3.36 to -2.35; diastolic blood pressure, MD: -0.66 mm Hg; 95% CI, -1.02 to -0.30), glycated hemoglobin (MD: -0.40%; 95% CI, -0.49 to -0.31), and low-density lipoprotein cholesterol (MD: -2.91 mg/dL; 95% CI, -5.28 to -0.53; MD: -0.87% change from baseline; 95% CI, -1.17 to -0.56). CONCLUSION Liraglutide is effective for weight control and can be a promising drug for cardiovascular protection in overweight and obese people.
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Affiliation(s)
- Shinje Moon
- Department of Endocrinology and Metabolism, Hallym University College of Medicine, Chuncheon,
Korea
| | - Jibeom Lee
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, Gwangju,
Korea
| | - Hye Soo Chung
- Department of Endocrinology and Metabolism, Hallym University College of Medicine, Chuncheon,
Korea
| | - Yoon Jung Kim
- Department of Endocrinology and Metabolism, Hallym University College of Medicine, Chuncheon,
Korea
| | - Jae Myung Yu
- Department of Endocrinology and Metabolism, Hallym University College of Medicine, Chuncheon,
Korea
| | - Sung Hoon Yu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri,
Korea
| | - Chang-Myung Oh
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, Gwangju,
Korea
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