Glucose-Lowering Effects and Low Risk of Hypoglycemia in Patients With Maturity-Onset

Diabetes of the Young When Treated With aGLP-1 Receptor Agonist: ADouble- Blind,

Randomized, Crossover Trial

Featured Article:

Signe H. Østoft, Jonatan I. Bagger, Torben Hansen, Oluf Pedersen,Jens Faber, Jens J. Holst, Filip K. Knop, and Tina Vilsbøll

Diabetes Care Volume 37: 1797-1805

July, 2014

STUDY OBJECTIVE 

• Hepatocyte nuclear factor 1 (HNF1A diabetes) is often treated with sulfonylureas that confer a high risk of hypoglycemia

• We evaluated treatment with GLP-1 receptor agonists (GLP-1RAs) in patients with HNF1A diabetes

Østoft S. H. et al. Diabetes Care 2014;37:1797-1805

STUDY DESIGN AND METHODS

• 16 patients with HNF1A diabetes received 6 weeks of treatment with a GLP-1RA (liraglutide) and placebo (tablets), as well as a sulfonylurea (glimepiride) and placebo (injections)

• Glimepiride was up-titrated once weekly in a treat-to-target manner

• Liraglutide was up-titrated once weekly to 1.8 mg once daily

• At baseline and at the end of each treatment period, a standardized liquid meal test was performed, including a 30-min light bicycle test

Østoft S. H. et al. Diabetes Care 2014;37:1797-1805

Østoft S. H. et al. Diabetes Care 2014;37:1797-1805

RESULTS

• Fasting plasma glucose (FPG) decreased during the treatment periods, with no difference between treatments

• Postprandial plasma glucose (PG) responses were lower with both glimepiride and liraglutide compared with baseline, with no difference between treatments

• 18 episodes of hypoglycemia occurred during glimepiride treatment and one during liraglutide treatment

Østoft S. H. et al. Diabetes Care 2014;37:1797-1805

Østoft S. H. et al. Diabetes Care 2014;37:1797-1805

Østoft S. H. et al. Diabetes Care 2014;37:1797-1805

CONCLUSIONS

• Six weeks of treatment with glimepiride or liraglutide lowered FPG and postprandial glucose excursions in patients with HNF1A diabetes

• Glucose-lowering effect was greater with glimepiride at the expense of a higher risk of exclusively mild hypoglycemia

Østoft S. H. et al. Diabetes Care 2014;37:1797-1805

Østoft S. H. et al. Diabetes Care 2014;37:1797-1805