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Kawata T, Kanamori A, Kubota A, Maeda H, Amamiya H, Takai M, Kaneshige H, Minagawa F, Iemitsu K, Kaneshiro M, Ishikawa M, Takeda H, Takuma T, Mokubo A, Machimura H, Obana M, Miyakawa M, Naka Y, Suzuki D, Terauchi Y, Toyoda M, Tanaka Y, Matsuba I. Is a switch from insulin therapy to liraglutide possible in Japanese type 2 diabetes mellitus patients? J Clin Med Res 2014; 6:138-44. [PMID: 24578756 PMCID: PMC3935523 DOI: 10.14740/jocmr1719w] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2014] [Indexed: 01/03/2023] Open
Abstract
Background To evaluate the efficacy of switching from insulin to the GLP-1 receptor agonist liraglutide in type 2 diabetes mellitus patients. Methods The subjects were 231 outpatients with type 2 diabetes mellitus being treated with liraglutide for the first time. For 161 patients, liraglutide was continued for 24 weeks (continuation group), and for 70 patients, liraglutide was discontinued before 24 weeks (discontinuation group). Fasting and postprandial blood glucose levels, HbA1c, body weight, and insulin dose were evaluated before the switch to liraglutide (baseline) and at 12 and 24 weeks of administration. Trends in HbA1c and weight were compared at 12 and 24 weeks of administration. Multiple regression analyses were conducted to identify clinical factors predicting a successful switch to liraglutide. Results Multiple regression analysis with ΔHbA1c as the dependent variable in the continuation group indicated that HbA1c at 12 weeks of administration decreased with higher baseline HbA1c and increased with higher baseline daily insulin doses. Multiple regression analysis with Δweight as the dependent variable indicated that Δweight at 24 weeks of liraglutide administration was higher with higher baseline daily insulin doses and longer duration of diabetes. Based on the area under the receiver operating characteristic curve, cut-off values of 19 units for daily insulin dose and nine years for duration of diabetes were identified. Conclusions Switching from insulin to liraglutide therapy is possible for carefully selected patients. Daily insulin dosage and duration of insulin therapy appear to be clinically useful indicators for the efficacy of liraglutide therapy.
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Affiliation(s)
- Takehiro Kawata
- The Study Group of the Diabetes Committee, Kanagawa Physicians Association, 3F Kanagawa-ken Sogo Iryo Kaikan, 3-1 Fujimi-cho, Naka-ward, Yokohama-city, Kanagawa 231-0037, Japan ; Department of Internal Medicine, Division of Metabolism and Endocrinology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae, Kawasaki, Kanagawa 216-8511, Japan
| | - Akira Kanamori
- The Study Group of the Diabetes Committee, Kanagawa Physicians Association, 3F Kanagawa-ken Sogo Iryo Kaikan, 3-1 Fujimi-cho, Naka-ward, Yokohama-city, Kanagawa 231-0037, Japan
| | - Akira Kubota
- The Study Group of the Diabetes Committee, Kanagawa Physicians Association, 3F Kanagawa-ken Sogo Iryo Kaikan, 3-1 Fujimi-cho, Naka-ward, Yokohama-city, Kanagawa 231-0037, Japan
| | - Hajime Maeda
- The Study Group of the Diabetes Committee, Kanagawa Physicians Association, 3F Kanagawa-ken Sogo Iryo Kaikan, 3-1 Fujimi-cho, Naka-ward, Yokohama-city, Kanagawa 231-0037, Japan
| | - Hikaru Amamiya
- The Study Group of the Diabetes Committee, Kanagawa Physicians Association, 3F Kanagawa-ken Sogo Iryo Kaikan, 3-1 Fujimi-cho, Naka-ward, Yokohama-city, Kanagawa 231-0037, Japan
| | - Masahiko Takai
- The Study Group of the Diabetes Committee, Kanagawa Physicians Association, 3F Kanagawa-ken Sogo Iryo Kaikan, 3-1 Fujimi-cho, Naka-ward, Yokohama-city, Kanagawa 231-0037, Japan
| | - Hideaki Kaneshige
- The Study Group of the Diabetes Committee, Kanagawa Physicians Association, 3F Kanagawa-ken Sogo Iryo Kaikan, 3-1 Fujimi-cho, Naka-ward, Yokohama-city, Kanagawa 231-0037, Japan
| | - Fuyuki Minagawa
- The Study Group of the Diabetes Committee, Kanagawa Physicians Association, 3F Kanagawa-ken Sogo Iryo Kaikan, 3-1 Fujimi-cho, Naka-ward, Yokohama-city, Kanagawa 231-0037, Japan
| | - Kotaro Iemitsu
- The Study Group of the Diabetes Committee, Kanagawa Physicians Association, 3F Kanagawa-ken Sogo Iryo Kaikan, 3-1 Fujimi-cho, Naka-ward, Yokohama-city, Kanagawa 231-0037, Japan
| | - Mizuki Kaneshiro
- The Study Group of the Diabetes Committee, Kanagawa Physicians Association, 3F Kanagawa-ken Sogo Iryo Kaikan, 3-1 Fujimi-cho, Naka-ward, Yokohama-city, Kanagawa 231-0037, Japan
| | - Masashi Ishikawa
- The Study Group of the Diabetes Committee, Kanagawa Physicians Association, 3F Kanagawa-ken Sogo Iryo Kaikan, 3-1 Fujimi-cho, Naka-ward, Yokohama-city, Kanagawa 231-0037, Japan
| | - Hiroshi Takeda
- The Study Group of the Diabetes Committee, Kanagawa Physicians Association, 3F Kanagawa-ken Sogo Iryo Kaikan, 3-1 Fujimi-cho, Naka-ward, Yokohama-city, Kanagawa 231-0037, Japan
| | - Tetsurou Takuma
- The Study Group of the Diabetes Committee, Kanagawa Physicians Association, 3F Kanagawa-ken Sogo Iryo Kaikan, 3-1 Fujimi-cho, Naka-ward, Yokohama-city, Kanagawa 231-0037, Japan
| | - Atsuko Mokubo
- The Study Group of the Diabetes Committee, Kanagawa Physicians Association, 3F Kanagawa-ken Sogo Iryo Kaikan, 3-1 Fujimi-cho, Naka-ward, Yokohama-city, Kanagawa 231-0037, Japan
| | - Hideo Machimura
- The Study Group of the Diabetes Committee, Kanagawa Physicians Association, 3F Kanagawa-ken Sogo Iryo Kaikan, 3-1 Fujimi-cho, Naka-ward, Yokohama-city, Kanagawa 231-0037, Japan
| | - Mitsuo Obana
- The Study Group of the Diabetes Committee, Kanagawa Physicians Association, 3F Kanagawa-ken Sogo Iryo Kaikan, 3-1 Fujimi-cho, Naka-ward, Yokohama-city, Kanagawa 231-0037, Japan
| | - Masaaki Miyakawa
- The Study Group of the Diabetes Committee, Kanagawa Physicians Association, 3F Kanagawa-ken Sogo Iryo Kaikan, 3-1 Fujimi-cho, Naka-ward, Yokohama-city, Kanagawa 231-0037, Japan
| | - Yoshikazu Naka
- The Study Group of the Diabetes Committee, Kanagawa Physicians Association, 3F Kanagawa-ken Sogo Iryo Kaikan, 3-1 Fujimi-cho, Naka-ward, Yokohama-city, Kanagawa 231-0037, Japan
| | - Daisuke Suzuki
- The Study Group of the Diabetes Committee, Kanagawa Physicians Association, 3F Kanagawa-ken Sogo Iryo Kaikan, 3-1 Fujimi-cho, Naka-ward, Yokohama-city, Kanagawa 231-0037, Japan
| | - Yasuo Terauchi
- Department of Endocrinology and Diabetes, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ward, Yokohama-city, Kanagawa 232-0024, Japan
| | - Masao Toyoda
- Division of Nephrology and Metabolism, Department of Internal Medicine, Tokai University School of Medicine, 143 Shimkasuya, Isehara, Kanagawa 259-11, Japan
| | - Yasushi Tanaka
- Department of Internal Medicine, Division of Metabolism and Endocrinology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae, Kawasaki, Kanagawa 216-8511, Japan
| | - Ikuro Matsuba
- The Study Group of the Diabetes Committee, Kanagawa Physicians Association, 3F Kanagawa-ken Sogo Iryo Kaikan, 3-1 Fujimi-cho, Naka-ward, Yokohama-city, Kanagawa 231-0037, Japan
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